You, the RN, assess a client who is in the 32nd week of pregnancy.
She fell and punctured her leg with a nail.
She states she has not had a tetanus immunization since infancy.
Which action will you include in her plan of care?

Choice A rationale

The fetal heartbeat can be heard with a Doppler at the fourth week of gestation is incorrect. At this early stage, the embryonic heart has only just begun to form, and its activity cannot be detected by Doppler.

Choice B rationale

The fetal heartbeat can be heard with a Doppler at the sixth week of gestation is incorrect. Although the heart begins to beat around this time, it is usually too faint to be detected by Doppler.

Choice C rationale

The fetal heartbeat can be heard with a Doppler at the seventh week of gestation is incorrect. It remains challenging to detect the fetal heartbeat this early with standard Doppler equipment.

Choice D rationale

The fetal heartbeat can be heard with a Doppler at the twelfth week of gestation is correct. By the end of the first trimester, the fetal heart is sufficiently developed and strong enough to be detected using Doppler ultrasound, allowing healthcare providers to monitor fetal well-being.

Choice A rationale: Administer IV fluids with electrolytes: This is crucial to rehydrate the client and correct electrolyte imbalances caused by excessive vomiting, a common complication of hyperemesis gravidarum.

Choice B rationale: Offer small, frequent meals high in protein: Small, frequent meals can help manage nausea and vomiting by preventing the stomach from becoming empty, while high-protein foods can provide necessary nutrients and energy.

Choice C rationale: Administer antiemetics as prescribed: Antiemetics can help control nausea and vomiting, improving the client's ability to tolerate oral intake and maintain hydration and nutrition.

Choice D rationale: Encourage the client to increase oral fluid intake immediately: While increasing oral fluid intake is beneficial, it may not be immediately feasible due to the severity of nausea and vomiting in hyperemesis gravidarum. Hence, initial IV fluid therapy is prioritized.

Choice E rationale: Perform continuous fetal monitoring: Continuous fetal monitoring is not typically necessary in the early stages of pregnancy, especially at 11 weeks of gestation. The primary focus should be on stabilizing the mother's condition to support overall pregnancy health.