The nurse is teaching a client about maternal hormones.The woman states that she has been unable to complete a full-term pregnancy.
According to her healthcare provider, she and her husband have been able to achieve fertilization but implantation never takes place.
This is most likely due to a lack of which hormone?

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

Rubella vaccination is contraindicated during pregnancy due to the risk of congenital rubella syndrome in the fetus. It should be administered postpartum if the client is non-immune.

Choice B rationale

Preterm labor is a concern at 28 weeks' gestation. Educating the client on signs and symptoms can help in early detection and management, potentially improving outcomes for both mother and baby.

Choice C rationale

Rh-negative mothers with a negative antibody screen should receive Rhogam at 28 weeks to prevent Rh sensitization. This is crucial to avoid hemolytic disease of the newborn in future pregnancies.

Choice D rationale

A positive urine analysis for leukocytes indicates a possible urinary tract infection. A clean catch urine culture is needed to identify the causative organism and guide appropriate antibiotic therapy.

Choice E rationale

The glucose challenge test result of 120 at 26 weeks is within normal limits, but a 3-hour diagnostic glucose tolerance test may be ordered if there's a high index of suspicion for gestational diabetes or other risk factors.

Choice F rationale

A blood transfusion is not indicated as the hemoglobin/hematocrit levels (11.0 mg/dl and 35%) are within acceptable limits for pregnancy.