The nurse caring for a woman hospitalized for hyperemesis gravidarum should expect that initial treatment will involve:

Choice A reason: Anxiety due to hospitalization is not a likely cause of the signs reported by the patient. Anxiety can cause some symptoms, such as headache, palpitations, or sweating, but it does not cause visual changes or epigastric pain. Anxiety is also not a common complication of pregnancy-induced hypertension, which is a condition characterized by high blood pressure and protein in the urine.

Choice B reason: Effects of magnesium sulfate are not a likely cause of the signs reported by the patient. Magnesium sulfate is a medication used to prevent seizures and lower blood pressure in patients with pregnancy-induced hypertension. It can cause some side effects, such as flushing, nausea, or drowsiness, but it does not cause headache, visual changes, or epigastric pain. In fact, magnesium sulfate can help relieve these symptoms by reducing the cerebral edema and vasospasm caused by pregnancy-induced hypertension.

Choice C reason: Worsening disease and impending convulsion are the most likely cause of the signs reported by the patient. These signs indicate that the patient is developing severe preeclampsia or eclampsia, which are life-threatening complications of pregnancy-induced hypertension. Preeclampsia is characterized by high blood pressure, protein in the urine, and signs of organ damage, such as headache, visual changes, epigastric pain, or decreased urine output. Eclampsia is the occurrence of seizures in a patient with preeclampsia. These conditions can lead to stroke, bleeding, placental abruption, or fetal distress, and require immediate medical attention.

Choice D reason: Gastrointestinal upset is not a likely cause of the signs reported by the patient. Gastrointestinal upset can cause some symptoms, such as nausea, vomiting, or abdominal pain, but it does not cause headache, visual changes, or epigastric pain. Gastrointestinal upset is also not a common complication of pregnancy-induced hypertension, which is a condition that affects the blood vessels and organs, not the digestive system.

Choice A reason: Urinary frequency is a common symptom of pregnancy, especially in the first and third trimesters, due to the increased pressure of the uterus on the bladder. It is not a sign of complication and does not need to be reported immediately.

Choice B reason: Rupture of membranes is the breaking of the amniotic sac, which can occur spontaneously or artificially before or during labor. It is a sign of impending delivery and can increase the risk of infection. It should be reported immediately to the health care provider.

Choice C reason: Heartburn accompanied by severe headache can indicate preeclampsia, a serious condition characterized by high blood pressure and proteinuria in pregnancy. It can lead to eclampsia, which is a life-threatening seizure disorder. It should be reported immediately to the health care provider.

Choice D reason: Decreased libido is a normal change in pregnancy, due to hormonal fluctuations, physical discomfort, and emotional stress. It is not a sign of complication and does not need to be reported immediately.

Choice E reason: Vaginal bleeding can indicate various complications in pregnancy, such as placenta previa, placental abruption, or miscarriage. It can pose a threat to the mother and the fetus. It should be reported immediately to the health care provider.