A pregnant client G1, PO with severe daily nausea and vomiting at 17 weeks is diagnosed with Hyperemesis Gravidarum. The nurse understands that which factor is most associated with the development of Hyperemesis Gravidarum?

A. Profuse, clear vaginal discharge is not characteristic of a hydatidiform mole. Vaginal bleeding associated with this condition is usually dark brown or bright red, often described as “prune juice–like”, rather than clear discharge.
B. An irregular fetal heart rate would be expected in a viable pregnancy with fetal distress, but a hydatidiform mole involves abnormal trophoblastic proliferation without a viable fetus (in most complete moles), so fetal heart activity is typically absent.
C. Human chorionic gonadotropin (hCG) levels are usually markedly elevated, not declining, in a hydatidiform mole due to abnormal proliferation of trophoblastic tissue. A rapid decline in hCG would be expected after treatment, not during initial presentation.
D. Excessive uterine enlargement is a classic finding in hydatidiform mole. The uterus is often larger than expected for gestational age due to abnormal growth of trophoblastic tissue and fluid-filled vesicles. This finding, along with markedly elevated hCG and abnormal vaginal bleeding, is a key diagnostic clue for this condition.

A. The hallmark symptom of an ectopic pregnancy is sharp or crampy abdominal pain localized to one side, corresponding to the location of the implanted embryo, usually in the fallopian tube. The pain may be sudden or intermittent, and sometimes radiates to the shoulder or neck if internal bleeding irritates the diaphragm. Early recognition is critical to prevent tubal rupture and hemorrhage.

B. Vaginal bleeding is often present in ectopic pregnancy, typically lighter or irregular compared to normal menses. Absence of bleeding does not rule out ectopic pregnancy; in fact, bleeding may be a key early symptom in combination with abdominal pain.

C. While nausea and vomiting are common in normal intrauterine pregnancies, they are not specific to ectopic pregnancy. Their presence alone does not suggest ectopic implantation.

D. In ectopic pregnancy, the uterus is usually small for gestational age or may show only minimal changes because the pregnancy is developing outside the uterine cavity. Uterine enlargement is more characteristic of a normal intrauterine pregnancy or molar pregnancy.