A pregnant client asks about the functions of the placenta.Which of the following items should the nurse NOT include in the teaching plan?

Choice A rationale

The sex of the fetus can be determined earlier through ultrasound or blood tests, making amniocentesis at 36 weeks unnecessary for this purpose.

Choice B rationale

Detection of metabolic disorders can also be done earlier in the pregnancy through other tests. Amniocentesis at 36 weeks is not typically used for this purpose.

Choice C rationale

Determining fetal lung maturity is a primary reason for performing an amniocentesis at 36 weeks gestation. This test assesses whether the fetus's lungs are developed enough for the baby to breathe independently after birth.

Choice D rationale

Identification of abnormal fetal cells can be done earlier in pregnancy through amniocentesis or other genetic tests. It is not the primary reason for amniocentesis at 36 weeks.

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.