A nurse is caring for a client who is at 12 weeks of gestation and has hyperemesis gravidarum. Which of the following manifestations should the nurse expect?
Decreased BP.
WBC count 15,000/mm³ (5,000 to 15,000/mm³).
Pruritus.
Hemoglobin 18 g/dL (11 to 16 g/dL). .
The Correct Answer is A
Choice A rationale
"Decreased BP.”. This is correct because hyperemesis gravidarum can lead to dehydration, which in turn can cause hypotension (decreased blood pressure).
Choice B rationale
"WBC count 15,000/mm³ (5,000 to 15,000/mm³).”. This is incorrect because while WBC count can be elevated due to stress or infection, it is not a primary manifestation of hyperemesis gravidarum.
Choice C rationale
"Pruritus.”. This is incorrect because pruritus is not commonly associated with hyperemesis gravidarum. It is more likely related to other conditions like cholestasis of pregnancy.
Choice D rationale
"Hemoglobin 18 g/dL (11 to 16 g/dL).”. This is incorrect because an elevated hemoglobin level is not a direct manifestation of hyperemesis gravidarum, although dehydration can potentially concentrate blood components and slightly elevate hemoglobin.
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Correct Answer is D
Explanation
Choice A rationale
This statement is incorrect because after a cesarean birth, clients are usually started on clear liquids and then gradually progress to regular food as tolerated. Swallowing safety is related to anesthesia recovery, not cesarean birth recovery.
Choice B rationale
This statement is incorrect because the client does not need to stay flat on their back for 24 hours. Early ambulation is encouraged to prevent complications such as deep vein thrombosis and promote recovery.
Choice C rationale
This statement is incorrect because the urinary catheter is typically removed within 24 hours after surgery to reduce the risk of urinary tract infections and encourage normal bladder function.
Choice D rationale
This statement is correct because after a cesarean birth, the nurse will frequently assess the uterus for firmness and massage it as needed to prevent postpartum hemorrhage.
Correct Answer is D
Explanation
Choice A rationale
Inserting the suppository 5 cm is generally insufficient for proper placement. The suppository needs to be placed further along the vaginal canal to be effective.
Choice B rationale
Applying petroleum jelly to the suppository is not recommended because it can interfere with the absorption and effectiveness of the medication.
Choice C rationale
Assisting the client into a prone position is not appropriate for inserting a vaginal suppository. The client should be in a lithotomy or supine position with legs bent.
Choice D rationale
Inserting the suppository along the posterior vaginal wall ensures proper placement and maximizes the effectiveness of the medication by allowing it to dissolve and be absorbed where it is needed.