A nurse is reviewing laboratory results for a client who has metabolic alkalosis. Which of the following blood gas values should the nurse expect?

A. Respiratory data: The client’s respirations are even and nonlabored, with clear lung sounds and an oxygen saturation of 94% on room air. Although the respiratory rate is mildly elevated, there are no signs of pulmonary edema or respiratory compromise requiring immediate follow-up.

B. Lower extremity data: The presence of 1+ dependent edema bilaterally can be a normal finding in pregnancy due to increased fluid volume and venous stasis. In isolation, this level of edema does not indicate a critical concern requiring urgent follow-up.

C. Nausea: Nausea and vomiting in the third trimester, especially when accompanied by headache and right epigastric pain, are concerning for severe preeclampsia. These symptoms suggest hepatic involvement and warrant prompt follow-up and evaluation.

D. Deep tendon reflex: Hyperreflexia with 3+ deep tendon reflexes indicates increased neuromuscular irritability. This finding is associated with preeclampsia and increases the risk for seizure activity, making it a priority for follow-up.

E. Blood pressure: A blood pressure of 156/96 mm Hg meets the criteria for hypertension in pregnancy. Persistent elevations place the client at risk for preeclampsia and related complications and require immediate provider notification.

F. Fundal height: At 30 weeks’ gestation, an expected fundal height is approximately 30 cm. A measurement of 26 cm suggests possible intrauterine growth restriction, which may be related to placental insufficiency and requires further assessment.

G. Weight data: A weight gain of 0.68 kg (1.5 lb) in one week may indicate abnormal fluid retention. Rapid weight gain in pregnancy is a concerning sign of worsening preeclampsia and should be followed up promptly.

A. Hematuria: Hematuria is not a typical adverse effect of methylergonovine. This medication primarily affects uterine smooth muscle and vascular tone, so urinary complications are uncommon.

B. Elevated blood pressure: Methylergonovine is a potent vasoconstrictor, which can lead to hypertension. Monitoring blood pressure is essential because severe elevations can increase the risk of stroke or cardiac complications, especially in clients with preexisting hypertension.

C. Uterine relaxation: Methylergonovine promotes uterine contraction, not relaxation. Uterine relaxation would be contrary to the intended therapeutic effect of preventing or controlling postpartum hemorrhage.

D. Diarrhea: Gastrointestinal upset, including nausea, vomiting, or diarrhea, can occur but is less common and typically mild. Blood pressure changes are the primary adverse effect requiring close monitoring.