A nurse is assisting with the admission of a client who has hyperemesis gravidarum.
Which of the following laboratory tests is the priority to complete?
Serum bilirubin.
Liver enzymes.
CBC.
Urinalysis for ketones.
The Correct Answer is D
Choice A rationale
Serum bilirubin is not the priority test for hyperemesis gravidarum. It is more relevant for assessing liver function and jaundice.
Choice B rationale
Liver enzymes may be elevated in hyperemesis gravidarum, but they are not the priority test. The primary concern is dehydration and electrolyte imbalance.
Choice C rationale
A CBC can provide information on the client’s overall health, but it is not the priority test for hyperemesis gravidarum. The focus should be on assessing hydration status.
Choice D rationale
Urinalysis for ketones is the priority test because it helps assess the severity of dehydration and malnutrition. The presence of ketones indicates that the body is breaking down fat for energy, which is a sign of inadequate caloric intake.
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Correct Answer is D
Explanation
Choice A rationale
Tingling in the fingers, also known as carpal tunnel syndrome, is more commonly associated with the later stages of pregnancy when fluid retention is more pronounced. It is not typically a common discomfort during the first trimester.
Choice B rationale
Round ligament pain is more common in the second trimester when the uterus is growing rapidly and the ligaments supporting it stretch. This type of pain usually manifests as sharp, shooting pain in the lower abdomen or groin.
Choice C rationale
Perineal discomfort and pressure are more common in the later stages of pregnancy, particularly in the third trimester, as the baby descends into the pelvis and prepares for birth. It is not typically a discomfort experienced during the first trimester.
Choice D rationale
Increased urgency and frequency of urination are common discomforts during the first trimester of pregnancy. This occurs due to hormonal changes and the growing uterus pressing on the bladder, which reduces its capacity.
Correct Answer is B
Explanation
Choice A rationale
Lying in a left side-lying position for 30 minutes after meals can help reduce heartburn symptoms by preventing stomach acid from flowing back into the esophagus. However, it is not the most effective recommendation for managing heartburn during pregnancy.
Choice B rationale
Taking sips of milk between meals can help neutralize stomach acid and provide relief from heartburn. Milk can act as a buffer, reducing the acidity in the stomach and alleviating discomfort.
Choice C rationale
Eating three large meals per day can exacerbate heartburn symptoms by increasing the amount of stomach acid produced. Smaller, more frequent meals are recommended to help manage heartburn during pregnancy.
Choice D rationale
Drinking a cup of black coffee before breakfast can worsen heartburn symptoms due to its acidic nature and caffeine content. It is not recommended for individuals experiencing frequent heartburn, especially during pregnancy.