A nurse is caring for a 28-year-old female client who is at 12 weeks of gestation and has been admitted to the emergency department with excessive vomiting for the past 48 hours. The client has lost 2.3 kg (5 lb) over 2 days.

Exhibits

The nurse is assessing the client 24 hours later. How should the nurse interpret the findings 24 hours later? For each finding, click to specify whether the finding is unrelated to the diagnosis, a sign of potential improvement, or a sign of potential worsening.

Choice A rationale
Airborne precautions are used for diseases that are spread through tiny droplets in the air, such as tuberculosis or chickenpox. Clostridium difficile is not spread in this manner.
Choice B rationale

Droplet precautions are used for diseases that are spread through larger droplets, such as influenza or pertussis. Clostridium difficile is not spread in this manner.
Choice C rationale
This is the correct answer. Contact precautions are used for diseases that are spread through direct contact with the patient or their environment. Clostridium difficile is a bacterium that can be present in feces and can contaminate surfaces, so contact precautions are appropriate.
Choice D rationale
Protective environment precautions are used for patients who have a compromised immune system, such as those undergoing stem cell transplants. These precautions are not typically used for patients with Clostridium difficile.

Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and dehydration during pregnancy. The client's laboratory results show signs consistent with dehydration and electrolyte imbalances, such as a low potassium level (3.3 mEq/L) and an elevated blood urea nitrogen (BUN) level (28 mg/dL).

Additionally, the presence of ketones in the urine (not explicitly mentioned in the provided laboratory results but commonly associated with hyperemesis gravidarum) indicates that the body is breaking down fat for energy due to inadequate oral intake and dehydration.

These findings suggest that the client is experiencing significant fluid and electrolyte disturbances, which are commonly seen in hyperemesis gravidarum. Therefore, the client is at risk of developing hyperemesis gravidarum based on the laboratory results indicating dehydration and electrolyte imbalances.