A nurse is caring for a pregnant client who is experiencing increased urinary protein levels.
What is the primary cause of this change?
Decreased glomerular permeability.
Decreased protein intake.
Increased glomerular filtration rate.
Increased tubular reabsorption.
The Correct Answer is C
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.
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Related Questions
Correct Answer is D
Explanation
This is because a pregnant client may experience frequent urination at night due to increased urinary output caused by the increased blood volume and renal function during pregnancy.
This symptom is more common in the first and third trimesters.
Choice A is wrong because increased glomerular permeability does not cause nocturia, but it may cause proteinuria, which is the presence of protein in the urine.
Choice B is wrong because decreased renal blood flow does not cause nocturia, but it may cause renal ischemia, which is a condition where the kidneys do not receive enough blood supply.
Choice C is wrong because increased tubular reabsorption does not cause nocturia, but it may cause water retention and edema, which are swelling of the body tissues due to fluid accumulation.
Correct Answer is A
Explanation
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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