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?

Prolactin is a hormone that is responsible for inhibiting ovulation and stimulating milk production during pregnancy.

It is produced by the anterior pituitary gland and increases throughout pregnancy.

Choice A is wrong because hCG (human chorionic gonadotropin) is a hormone that is produced by the placenta and maintains the corpus luteum, which secretes progesterone and estrogen.

hCG does not inhibit ovulation or stimulate milk production.

Choice B is wrong because progesterone is a hormone that is produced by the corpus luteum and the placenta and supports the endometrium, prevents uterine contractions, and prepares the breasts for lactation.

Progesterone does not inhibit ovulation or stimulate milk production.

Choice C is wrong because estrogen is a hormone that is produced by the corpus luteum and the placenta and stimulates uterine growth, blood flow, and breast duct development.

Estrogen does not inhibit ovulation or stimulate milk production.

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.