A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

Elevated blood pressure

Leukopenia

Hydramnios

Ketonuria

Answer and Explanation

The Correct Answer is C

A. Elevated blood pressure is typically associated with gestational hypertension or preeclampsia rather than hyperemesis gravidarum. In hyperemesis, the significant fluid loss through protracted vomiting more commonly leads to hypovolemia and a subsequent decrease in systemic blood pressure. While compensatory tachycardia may occur, hypertension is not a direct scientific expectation for this clinical condition.

B. Leukopenia, which is a decrease in the white blood cell count, is not a typical finding in clients suffering from hyperemesis gravidarum. Hemoconcentration caused by severe dehydration may actually result in a relative increase in various laboratory values, including hematocrit and occasionally white cell counts. There is no physiological mechanism within this disorder that causes the bone marrow suppression required for leukopenia.

C. Hydramnios, or excessive amniotic fluid volume, is generally associated with fetal anomalies or maternal diabetes rather than severe vomiting. Hyperemesis gravidarum is characterized by a state of maternal fluid volume deficit rather than an excess of amniotic fluid. In severe, untreated cases, maternal dehydration might actually lead to decreased placental perfusion and a potential reduction in amniotic fluid.

D. Ketonuria is a critical finding in hyperemesis gravidarum that indicates the body has shifted to an anaerobic metabolic state. Because the client cannot retain sufficient carbohydrates for energy, the body begins catabolizing adipose tissue to produce fuel, resulting in the accumulation of ketone bodies. The presence of these ketones in the urine confirms that the client is experiencing metabolic starvation and requires immediate intervention.

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Correct Answer is B

Explanation

A) Incorrect- Foul-smelling vaginal discharge might indicate infection but is not the priority over the presence of meconium-stained amniotic fluid.
B) Correct- Fetal heart rate is important to monitor, but the presence of meconium- stained amniotic fluid has higher priority. fetal heart tones 98/min, because this indicates fetal distress and requires immediate intervention.
C) Incorrect - Amniotic fluid with meconium noted could indicate fetal hypoxia or distress, but it is not always a sign of a problem and depends on other factors such as gestational age and fetal activity.
D) Incorrect- Maternal temperature elevation might indicate infection but is not the priority over assessing the condition of the amniotic fluid and the baby.

A. "Progestin-only birth control pills are preferred for contraception during lactation." B. "Taking birth control pills while breastfeeding can increase your risk for breast cancer. C. "You do not need birth control pills as long as you are lactating." D. "Birth control pills are contraindicated for breastfeeding clients."

Correct Answer is A

Explanation

A) Correct - "Progestin-only birth control pills are preferred for contraception during lactation." Progestin-only pills are generally considered safer for breastfeeding mothers as they are less likely to affect milk supply.
B) Incorrect- There is no strong evidence suggesting that taking birth control pills while breastfeeding increases the risk of breast cancer.
C) Incorrect- While breastfeeding can have contraceptive effects, relying solely on breastfeeding for contraception is not a foolproof method. It's recommended to use additional birth control methods if desired.
D) Incorrect- Birth control pills are not contraindicated for breastfeeding clients, especially if they are progestin-only pills. The preferred method, however, is progestin-only rather than combined hormonal pills.

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A nurse is caring for a client who has hyperemesis gravidarum. The nurse should identify that the client is at risk for which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is collecting data from a client who is at 34 weeks of gestation and reports having a sudden gush of vaginal fluid. Which of the following manifestations is the priority?

Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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