Hyperemesis gravidarum

a client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis gravidarum. WHich of the following factors predisposes a client to the development of this? 1. trophoblastic disease 2. maternal age > 35 y.o 3. malnourished or underweight clients 4. low levels of HCG

1. Trophoblastic disease associated w/ hyperemesis gravobesity and maternal age younger than 20 y.o. are risk factors too.High levels of estrogen HCG have also been associated with the development

A patient with hyperemesis gravidarum says to the nurse, "I am so worried that all this vomiting will cause me to miscarry my baby." Which is the appropriate therapeutic response from the nurse? 1. "Tell me what makes you concerned about this." 2. "As long as you don't lose more than 5% of your weight, you will probably have a normal pregnancy." 3. "It is estimated that around 25% of all pregnancies end in miscarriage." 4. "I will do everything I can to try to prevent that from happening."

2. "As long as you don't lose more than 5% of your weight, you will probably have a normal pregnancy. The fetal fibronectin test is collected from vaginal fluid not blood draw.

a 21 y.o. client, 6 weeks pregnant, is diagnosed with hyperemesis gravidum. This excessive vomiting during pregnancy will often result in which of the following? 1. bowel perforation 2. electrolyte imbalance 3. miscarriage 4. PIH

2. ELECTROLYTE IMBALANCE Excessive vomiting in clients with hyperemesis grav often causes weight loss / fluid and electrolyte, acid base imbalance.PIH and bowel perforation arent r/t hyper gravthe effects of hyper grav on the fetus depend on the severity of the disorder.clients w/ severe hyper grav may have low birth weight infant, but the disorder isnt life threatening to the fetus.

A pregnant client at 14 weeks' gestation is diagnosed with hyperemesis gravidarum. The most recent vital signs are: blood pressure 95/48, pulse 114, respirations 24. Which order should the nurse implement first? 1. Weigh the client. 2. Encourage clear liquids orally. 3. Give 1 L of lactated Ringer solution IV. 4. Administer 30 mL Maalox (magnesium hydroxide) orally.

3 Explanation: 1. Weighing the client provides information on weight gain or loss, but it is not the top priority in a client with excessive vomiting during pregnancy. The vital signs indicate hypovolemia. The client needs IV fluids. 2. The client needs IV fluids because of the vital signs indicating hypovolemia. Oral fluids are not likely to be tolerated well by a client with hyperemesis. Lack of tolerance of oral fluids through excessive vomiting is what has led to the hypovolemia. 3. The vital signs indicate hypovolemia. Giving this client a liter of lactated Ringer solution intravenously will reestablish vascular volume and bring the blood pressure up, and the pulse and respiratory rate down. 4. The vital signs indicate hypovolemia. There is no indication that the client has dyspepsia. The client needs IV fluids.Page Ref: 299

Which of the following complications can be potentially life threatening and can occur in a client receiving a tocolytic agent? 1. diabetic ketoacidosis 2. hyperemesis gravidarum 3. pulmonary edema 4. sickle cell anemia

3. pulmonary edema Tocolytics are used to stop labor contractions.The most common adverse effect associated with the use of these drugs is pulmonary edema.Clients who dont have diabetes dont need to be observed for diabetic ketoacidosis.Hyperemesis gravidium doesnt result from tocolytic use.Sickle cell anemia is an inherited genetic condition and doesnt develop spontaneously

A patient experiencing hyperemesis gravidarum has just been admitted with vomiting and severe dehydration. Which of the following orders would be carried out first by the nurse? 1.Weigh the patient. 2.Administer an oral prenatal vitamin. 3.Provide intravenous hydration. 4.Assist the patient with oral hygiene

3.Provide intravenous hydration.

A patient is admitted to the hospital with hyperemesis gravidarum. The patient is malnourished and severely dehydrated. The care plan should be altered to include which interventions? a.Hyperalimentation b.IV fluids and electrolyte replacement c.Hormone replacement therapy d.Vitamin supplements

B Medical treatment is aimed at meeting fluid and electrolyte replacement.

Which short term client outcome would be most appropriate for a client admitted to the hospital with hyperemesis gravidarum and the nursing diagnosis of Imbalanced Nutrition: Less than body requirements? a. Measures own hourly intake and output (I&O) b. Maintains present weight c. Identifies favorite foods in the diet d. Verbalizes risks to the fetus

B Rationale: A short-term outcome of maintained weight is appropriate while the client is being stablized in the hospital. While I & O are important measurements, they do not need to be done hourly, and this intervention would help evaluate whether a goal of fluid balance is maintained. Being able to identify favorite foods is not sufficient to assure a client outcome of Adequate Nutritional Intake. Verbalizing risks of malnutrition to the fetus does nothing to alter the condition.

A pregnant woman at 14 weeks of gestation is admitted to the hospital with a diagnosis of hyperemesis gravidarum. The primary goal of her treatment at this time is to: A. Rest the gastrointestinal (GI) tract by restricting all oral intake for 48 hours.' B. Reduce emotional distress by encouraging the woman to discuss her feelings. C. Reverse fluid, electrolyte, and acid-base imbalances. D. Restore the woman's ability to take and retain oral fluid and foods.

C. Reverse fluid, electrolyte, and acid-base imbalances.

A patient with hyperemesis gravidarum asks the nurse what would have happened if she had not come to the hospital. What result is the best response by the nurse? a.A large for gestational age infant b.Anorexia nervosa c.Preterm delivery d.Maternal or fetal death

D If untreated, hyperemesis gravidarum can result in maternal or fetal death.

A client who is 18 weeks' gestation has been diagnosed with a hydatiform mole (gestational trophoblastic disease -GTD). In additional to brown vaginal drainage, which of the following s/sx would the nurse expect to see? A. Diarrhea and hyperthermia B. Polycythemia C. Polydipsia D. Hyperemesis and hypertension

D. Hyperemesis and hypertension hyperemesis (increased levels of hCG)

The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would supportthe diagnosis of hyperemesis gravidarum? a. Hypercalcemia. b. Hypokalemia c. Hyperkalemia. d. Hypocalcemia

Hypokalemia. In severe cases, hyperemesis causes dehydration, which leads to fluid-electrolyteimbalance. Severe potassium loss can disrupt cardiac functioning. Potassium loss (hypokalemia),not hyperkalemia, is characteristic of hyperemesis gravidarum. Neither hypercalcemia norhypocalcemia (low calcium) is characteristic of hyperemesis gravidarum.

If a client does not respond to standard home treatment for severe hyperemesis gravidarum,the nurse will anticipate adding which therapy on an outpatient basis? a. Low-fat soft diet. b. Complex carbohydrates with limited liquids. c. IV fluids. d. Total parenteral nutrition.

IV fluids.Rationale: If the woman does not respond to standard approaches to the control of nausea andvomiting in pregnancy, she might require intravenous (IV) fluids on an outpatient basis. Totalparenteral nutrition would be started only if the client were unresponsive to IV hydration. Lowfat soft diet and complex carbohydrates with limited liquids are progressive diets after the clientis stabilized for hyperemesis gravidarum.

A client has an extremely high quantitative HCG level. What could the reason be? Select all that apply. a. impending misscarriage b. multi gestation preg c. hydatiform mold d. Rh sensitivity e. hyperemesis gravidarum

a. c. e. High levels of HCG can be seen in a muli gestation preg, hydatiform mole, or hyperemesis gravidarum.

A pregnant patient tells the nurse that she has been nauseated and vomiting. How will the nurse explain that hyperemesis gravidarum is distinguished from morning sickness? a. Hyperemesis gravidarum usually lasts for the duration of the pregnancy b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances. c. Sensitivity to smells is usually the cause of vomiting in hyperemesis gravidarum. d. The woman with hyperemesis gravidarum will have persistent vomiting without weight loss.

b. Hyperemesis gravidarum causes dehydration and electrolyte imbalances. Dehydration and electrolyte imbalances result from persistent nausea and vomiting associated with hyperemesis gravidarum. Dehydration impairs the perfusion to the placenta.

A client has been admitted with a diagnosis of hyperemesis gravidarum. Which of the following orders written by the primary health care provider is highest priority for the nurse to complete? a. obtain complete blood count b. start intravenous with multivitamins c. check admission weight d. obtain urine for urinalysis

b. start intravenous with multivitamins

A pregnant client with hyperemesis gravidarum needs advice on how to minimize nausea and vomiting. Which instruction should the nurse give this client? a. lie down or recline for at least 2 hours after eating b. Avoid dry crackers, toast, and soda c. Eat small, frequent meals throughout the day d. Decrease intake of carbonated beverages

c. Eat small, frequent meals throughout the day this will minimize N/V

A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client? a. administer total parenteral nutrition b. administer an antiemetic c. set up for a percutaneous endoscopic gastrostomy d. administer IV NS with vitamins and e-

d. administer IV NS with vitamins and e-