A nurse is caring for a pregnant client who has hyperemesis gravidarum and is receiving IV fluids and antiemetics in an acute care facility.
Which of the following outcomes indicates that treatment has been effective?
The client reports a decrease in nausea and vomiting.
The client gains 1 kg (2.2 lb) in 24 hr.
The client's urine specific gravity is 1.035
The client's hematocrit is 38%.
The Correct Answer is A
The correct answer is choice A. The client reports a decrease in nausea and vomiting.
This indicates that the treatment has been effective in reducing the symptoms of hyperemesis gravidarum and improving the quality of life of the client.
Choice B is wrong because weight gain alone is not a reliable indicator of treatment effectiveness.
Weight gain may be due to fluid retention or other factors unrelated to nausea and vomiting.
Choice C is wrong because urine specific gravity of 1.035 is high and indicates dehydration, which is a complication of hyperemesis gravidarum.
The normal range of urine specific gravity is 1.005 to 1.0302.
Choice D is wrong because hematocrit of 38% is within the normal range for pregnant women (33 to 39%) and does not reflect the severity or improvement of hyperemesis gravidarum.
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Correct Answer is C
Explanation
Increased glomerular filtration rate.
This is because during pregnancy, the renal blood flow and glomerular filtration rate increase to meet the increased metabolic demands of the mother and fetus.
This can result in increased urinary protein excretion, which is usually mild and does not indicate renal damage.
Choice A is wrong because decreased glomerular permeability would reduce the amount of protein that can pass through the glomerulus and into the urine.
Choice B is wrong because decreased protein intake would not affect the urinary protein levels, unless the intake is severely deficient.
Choice D is wrong because increased tubular reabsorption would decrease the amount of protein that is excreted in the urine, as the tubules would reabsorb more protein from the filtrate and return it to the blood.
Correct Answer is D
Explanation
Peristalsis and uterine contractility would increase.
This is because progesterone is a hormone that relaxes the smooth muscles of the uterus and the gastrointestinal tract during pregnancy.
If progesterone were reduced or withdrawn, the uterus would contract more and peristalsis would increase, leading to possible preterm labor and digestive problems.
Choice A is wrong because insulin resistance would be decreased, not increased, by lower progesterone levels.
Progesterone increases insulin resistance during pregnancy to ensure adequate glucose supply for the fetus.
Choice B is wrong because sweat and sebaceous glands would decrease production, not increase, by lower progesterone levels.
Progesterone stimulates the activity of these glands during pregnancy to regulate body temperature and protect the skin from infections.
Choice C is wrong because pyrosis (heartburn) would decrease in frequency, not increase, by lower progesterone levels.
Progesterone relaxes the lower esophageal sphincter during pregnancy, allowing gastric acid to reflux into the esophagus and cause pyrosis.
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