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?

This change alters the center of gravity and posture of the body because the uterus expands and shifts higher as the fetus grows during pregnancy.

This causes an increased strain on the muscles and ligaments supporting the vertebral column and leads to lower back pain.

Choice A is wrong because increased joint laxity does not alter the center of gravity and posture of the body.

It is caused by hormonal changes that loosen the ligaments throughout the body, resulting in decreased stability of the joints.

Choice C is wrong because increased muscle strain does not alter the center of gravity and posture of the body.

It is a consequence of the shift in the center of gravity and the weight gain during pregnancy, which put more pressure on the back muscles.

Choice D is wrong because decreased muscle strength does not alter the center of gravity and posture of the body.

It is not a common musculoskeletal change during pregnancy, although some women may experience fatigue or weakness due to hormonal changes or anemia.

Serum creatinine and urea are waste products of protein metabolism that are normally filtered by the kidneys and excreted in urine.

In pregnancy, the glomerular filtration rate (GFR) increases by about 50%, which means more creatinine and urea are cleared from the blood.Therefore, serum creatinine and urea levels decrease in pregnancy compared to nonpregnant women.

A. Increased serum creatinine and urea levels are wrong because they indicate impaired kidney function or dehydration, which are not normal in pregnancy.

C. Unchanged serum creatinine and urea levels are wrong because they do not reflect the increased GFR in pregnancy.

D. Increased glomerular filtration rate is correct but it is not a finding regarding serum creatinine and urea levels, which are the focus of the question.

Normal ranges for serum creatinine and urea vary depending on the laboratory and the units used, but based on a nonpregnant reference interval of 45-90 μmol/l (0.51-1.02 mg/dl) for creatinine and 2.5-6.4 mmol/l (7-18 mg/dl) for urea, a serum creatinine of >77 μmol/l (0.87 mg/dl) and a blood urea of >8.5 mmol/l (24 mg/dl) should be considered outside the normal range for pregnancy.