The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve:

Enteral nutrition (TPN) to correct nutritional deficits

Small frequent meals

Corticosteroids to reduce inflammation

IV therapy to correct fluid and electrolyte imbalances

Answer and Explanation

The Correct Answer is D

A. Enteral nutrition (TPN) to correct nutritional deficits. Total parenteral nutrition (TPN) is only considered in severe cases where oral and IV hydration fail. The initial treatment focuses on correcting dehydration and electrolyte imbalances before considering more invasive nutritional support.

B. Small frequent meals. While small, frequent meals may help manage nausea in mild cases of pregnancy-related nausea and vomiting, they are not sufficient for treating hyperemesis gravidarum, which involves severe, persistent vomiting leading to dehydration and electrolyte imbalances.

C. Corticosteroids to reduce inflammation. Corticosteroids are not the first-line treatment for hyperemesis gravidarum. They may be used in refractory cases where standard treatments fail, but IV fluids and antiemetics are prioritized initially.

D. IV therapy to correct fluid and electrolyte imbalances. The primary concern in hyperemesis gravidarum is severe dehydration and electrolyte disturbances due to excessive vomiting. IV fluids, often with electrolytes and thiamine, are the first step in stabilizing the patient before introducing oral intake.

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Correct Answer is D

Explanation

A. Preterm labor. Methotrexate is not used for preterm labor. Medications such as tocolytics (e.g., nifedipine, magnesium sulfate, or terbutaline) are typically used to delay labor and improve neonatal outcomes, but methotrexate does not serve this purpose.

B. Abruptio placentae. Methotrexate is not indicated for abruptio placentae, which is the premature separation of the placenta from the uterine wall. Management of abruptio placentae focuses on stabilizing the mother, monitoring fetal well-being, and delivering the baby if necessary.

C. Pre-eclampsia. Methotrexate does not treat pre-eclampsia. The management of pre-eclampsia includes antihypertensive medications, magnesium sulfate for seizure prevention, and delivery of the baby when indicated.

D. Unruptured ectopic pregnancy. Methotrexate is the first-line treatment for an unruptured ectopic pregnancy. It works by inhibiting rapidly dividing trophoblastic cells, stopping the growth of the ectopic pregnancy while preserving the fallopian tube. It is only used in stable patients with small, unruptured ectopic pregnancies and no signs of internal bleeding.

A. Call for a STAT magnesium level B. Do nothing, this is the expected action of magnesium C. Prepare to administer hydralazine D. Decrease or Discontinue the magnesium sulfate infusion

Correct Answer is D

Explanation

A. Call for a STAT magnesium level. While obtaining a magnesium level is important to confirm magnesium toxicity, the priority action is to stop or reduce the infusion immediately to prevent further toxicity and respiratory depression.

B. Do nothing, this is the expected action of magnesium. Absent deep tendon reflexes, lethargy, and respiratory depression (RR 9) are signs of magnesium toxicity, not expected therapeutic effects. Immediate intervention is necessary to prevent worsening respiratory and cardiac complications.

C. Prepare to administer hydralazine. Hydralazine is used to treat hypertension in preeclampsia, but this patient’s blood pressure is not critically high, and the primary concern is magnesium toxicity, not hypertension. Administering hydralazine would not address the immediate life-threatening issue.

D. Decrease or Discontinue the magnesium sulfate infusion. The first action in magnesium toxicity is to stop or reduce the infusion to prevent further accumulation. If symptoms worsen, calcium gluconate, the antidote for magnesium toxicity, may be administered to reverse its effects, especially if respiratory depression progresses.

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The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve:

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Naxlex Comprehensive Predictor Exams

The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve: