A patient has tested positive for a sexually transmitted infection (STI). Which actions are essential in the management of this condition?

Rationale for correct condition: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte imbalance. The client's significant weight loss of 2.8 kg (6.2 lb) in two weeks, increased nausea and vomiting, and decreased appetite are classic symptoms. The elevated BUN level suggests dehydration, which aligns with hyperemesis gravidarum. The absence of abdominal pain and the presence of facial pallor further support this condition.

Rationale for actions:

1. Initiate IV fluid therapy to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting.
2. Administer ondansetron IV to control nausea and vomiting, improving the client's ability to tolerate oral intake.

Rationale for parameters:

1. Weight should be monitored to assess the effectiveness of interventions and ensure the client is regaining or maintaining a healthy weight.
2. Urine output indicates hydration status and kidney function, helping to evaluate the adequacy of fluid replacement.

Rationale for incorrect conditions:

• Cholecystitis: The client denies abdominal or epigastric pain, which is a key symptom of cholecystitis.
• Gestational diabetes mellitus: There is no mention of elevated blood glucose levels or other diabetic symptoms.
• Preeclampsia: The client's blood pressure is within normal range, and there are no signs of hypertension or proteinuria.

Choice A rationale

Lanugo is a fine hair that covers the fetus but does not primarily protect the skin from amniotic fluid exposure. It mainly helps in thermoregulation and the adherence of the vernix caseosa.

Choice B rationale

While skin care after birth is important, applying cream post-delivery does not explain why the skin is protected during gestation.

Choice C rationale

Vernix caseosa is a protective, cheese-like coating that covers the fetus's skin. It provides a barrier against the amniotic fluid, preventing maceration of the skin during the pregnancy.

Choice D rationale

Although subcutaneous fat develops in the fetus, it is not responsible for protecting the skin from amniotic fluid. The primary protective mechanism is the vernix caseosa.