During the initial visit with the nurse at the fertility clinic, the patient asks what effect cigarette smoking or heavy alcohol intake has on the ability to conceive.
What is the nurse's best response?

Choice A rationale

50% of the offspring have a chance of developing the disease from the affected parent. Autosomal dominant inheritance means that a single copy of the altered gene in each cell is sufficient to cause the disorder. Thus, each child of an affected parent has a 50% chance of inheriting the condition.

Choice B rationale

Diseases transmitted from a carrier mother to her son typically describe X-linked recessive inheritance, not autosomal dominant. In autosomal dominant conditions, both males and females can be affected, and it doesn't depend on the sex of the parent transmitting the gene.

Choice C rationale

All of the offspring will develop the disease is incorrect. In autosomal dominant inheritance, there is a 50% chance of passing the altered gene to the offspring, not 100%.

Choice D rationale

50% of the offspring will be carriers of the disease from the affected parent is incorrect for autosomal dominant inheritance. There are no "carriers" in autosomal dominant diseases; individuals either have the disease or they don't, based on whether they inherit the altered gene.

Rationale for correct condition: Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy, leading to dehydration, weight loss, and electrolyte imbalance. The client's significant weight loss of 2.8 kg (6.2 lb) in two weeks, increased nausea and vomiting, and decreased appetite are classic symptoms. The elevated BUN level suggests dehydration, which aligns with hyperemesis gravidarum. The absence of abdominal pain and the presence of facial pallor further support this condition.

Rationale for actions:

1. Initiate IV fluid therapy to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting.
2. Administer ondansetron IV to control nausea and vomiting, improving the client's ability to tolerate oral intake.

Rationale for parameters:

1. Weight should be monitored to assess the effectiveness of interventions and ensure the client is regaining or maintaining a healthy weight.
2. Urine output indicates hydration status and kidney function, helping to evaluate the adequacy of fluid replacement.

Rationale for incorrect conditions:

• Cholecystitis: The client denies abdominal or epigastric pain, which is a key symptom of cholecystitis.
• Gestational diabetes mellitus: There is no mention of elevated blood glucose levels or other diabetic symptoms.
• Preeclampsia: The client's blood pressure is within normal range, and there are no signs of hypertension or proteinuria.