A nurse is educating a client who has a urinary alteration about the common causes of dysuria. Which of the following client statements indicates an understanding of the teaching?

Rationale for Correct Findings:

• Spontaneous abortion: The client is at 10 weeks gestation with moderate, bright red vaginal bleeding, abdominal cramping, and an open cervix. These findings are classic indicators of an inevitable spontaneous abortion, where pregnancy loss is imminent and cannot be prevented.
• Cervical dilation: Cervical dilation during early pregnancy, especially in the presence of bleeding and cramping, indicates that the pregnancy is not viable. The open cervix confirms the uterus is preparing to expel its contents, consistent with spontaneous abortion.

Rationale for Incorrect Findings:

• Ectopic pregnancy: Ectopic pregnancies typically present with unilateral pelvic pain and are usually associated with lower hCG levels than expected for gestational age. A confirmed intrauterine pregnancy with an open cervix and high hCG makes ectopic pregnancy unlikely.
• Molar pregnancy: Molar pregnancies are characterized by markedly elevated hCG levels, larger-than-expected uterine size, and sometimes passage of grape-like vesicles. The client's symptoms do not fit this profile, making this diagnosis less likely.
• hCG levels: The hCG level of 30,000 IU/L is within the normal range for 10 weeks gestation and does not indicate any problem. It supports a pregnancy of appropriate dating, not necessarily a spontaneous abortion.
• History of chlamydia infections: A history of recurrent chlamydia is a risk factor for ectopic pregnancy due to potential fallopian tube scarring. However, it does not directly support a current diagnosis of spontaneous abortion without additional findings.

A. Methylprednisolone: This corticosteroid is commonly used to reduce inflammation in conditions like pneumonia. One of its known adverse effects is hyperglycemia, especially during stress or infection, due to its role in increasing gluconeogenesis and decreasing peripheral glucose uptake.
B. Ondansetron: This antiemetic is used to prevent nausea and vomiting. It does not significantly affect blood glucose levels and is not associated with hyperglycemia as an adverse effect.
C. Guaifenesin: As an expectorant, guaifenesin helps loosen mucus in the airways but has no known effect on glucose metabolism. It is not linked to elevated blood glucose in clinical use.
D. Amoxicillin: This antibiotic is effective in treating bacterial pneumonia but does not impact glucose levels. Hyperglycemia is not a typical adverse effect of this medication.