A nurse is planning care for a client who is at 16 weeks of gestation and has hyperemesis gravidarum. Which of the following actions should the nurse anticipate taking?

Administer a calcium channel blocker.

Encourage foods that are low in proteins.

Monitor for glycosuria.

Monitor IV fluid therapy.

Answer and Explanation

The Correct Answer is D

A. Administer a calcium channel blocker. Calcium channel blockers are used primarily for hypertension, angina, and certain cardiac conditions. They are not standard treatment for hyperemesis gravidarum, which is managed with fluid replacement, antiemetics, and nutritional support to prevent dehydration and electrolyte imbalances.
B. Encourage foods that are low in proteins. Protein intake is essential for fetal growth and maternal health. Clients with hyperemesis gravidarum may tolerate small, frequent meals with bland, high-protein foods better than low-protein options. Avoiding protein is not a recommended intervention, as it does not reduce nausea and may contribute to nutritional deficiencies.
C. Monitor for glycosuria. While glycosuria can occur during pregnancy, it is more relevant in the assessment of gestational diabetes rather than hyperemesis gravidarum. The primary concern in hyperemesis gravidarum is dehydration and electrolyte imbalances rather than glycosuria.
D. Monitor IV fluid therapy. Clients with hyperemesis gravidarum often experience severe nausea and vomiting, leading to dehydration and electrolyte imbalances. IV fluid therapy is a critical intervention to restore hydration, correct electrolyte imbalances, and prevent complications such as ketonuria and hypotension.

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Correct Answer is B

Explanation

A. Believes that his brother's death will be reversible. This response is more typical of preschool-aged children (ages 3 to 5), who often perceive death as temporary or reversible, similar to sleep or separation. School-age children, however, begin to understand the finality of death, though they may still struggle with its implications.
B. Believes his bad behavior is causing his brother's death. School-age children (ages 6 to 12) often engage in magical thinking and may believe that their actions, thoughts, or behaviors are responsible for events, including illness and death. They may feel guilt and self-blame, thinking that past misbehavior contributed to their sibling's condition. Providing reassurance and education about the medical causes of the illness can help alleviate these feelings.
C. Alienates himself from his peers. While social withdrawal can occur in grieving children, school-age children typically seek peer support and may use friendships as a coping mechanism. Alienation is more commonly seen in adolescents, who might isolate themselves due to difficulty expressing emotions or fear of burdening others.
D. Regresses to an earlier developmental level. Regression, such as bedwetting, clinging behavior, or baby talk, is more commonly seen in younger children, particularly toddlers and preschoolers, when they experience stress or grief. School-age children are more likely to express distress through guilt, sadness, or behavioral changes rather than regression.

A. "You should only drink 2 cups of coffee per day." B. "You should eat three large meals and two snacks per day." C. "You should lay down for 1 hour following a meal." D. "You should elevate the head of the bed while sleeping."

Correct Answer is D

Explanation

A. "You should only drink 2 cups of coffee per day." While limiting coffee intake can be beneficial for some individuals with GERD, the recommendation should focus on overall caffeine intake rather than a specific amount. Caffeine can relax the lower esophageal sphincter and exacerbate symptoms, so some individuals may need to eliminate it entirely.
B. "You should eat three large meals and two snacks per day." Eating large meals can increase intra-abdominal pressure and exacerbate GERD symptoms. Instead, clients should be encouraged to eat smaller, more frequent meals throughout the day to help minimize reflux.
C. "You should lay down for 1 hour following a meal." Laying down after eating can increase the likelihood of reflux and heartburn. Clients should be advised to remain upright for at least 2 to 3 hours after meals to help prevent symptoms.
D. "You should elevate the head of the bed while sleeping." Elevating the head of the bed is a recommended practice for clients with GERD. This position can help prevent nighttime reflux by allowing gravity to keep stomach acid from rising into the esophagus, thereby reducing symptoms and improving sleep quality.

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A nurse is planning care for a client who is at 16 weeks of gestation and has hyperemesis gravidarum. Which of the following actions should the nurse anticipate taking?

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