A nurse is caring for a client at 12 weeks gestation who is admitted for hyperemesis gravidarum. Which clinical manifestation should the nurse expect?

Question

A nurse is caring for a client at 12 weeks gestation who is admitted for hyperemesis gravidarum.  Which clinical manifestation should the nurse expect?

Quizplus · Accepted Answer

11ecbb05_cbf1_1e75_b433_2f54fb029eb4_MD0009_00 Hyperemesis gravidarum (HG) is characterized by severe, persistent nausea and vomiting during pregnancy that usually leads to considerable weight loss (ie, ≥5% of prepregnancy weight), fluid and electrolyte imbalances (eg, hypokalemia), and nutritional deficiencies. Clients with HG may require hospitalization for IV fluid replacement and antiemetic therapy. Routine laboratory assessment for HG includes urinalysis dipstick testing to monitor the client's health status. Expected findings include an elevated urine specific gravity and ketonuria (Option D). Urine specific gravity increases when urine is concentrated due to dehydration, and ketones are a by-product of the fat breakdown that occurs in starvation states. (Option A) Abdominal pain and fever are not expected findings with HG. Such findings, especially when associated with nausea and vomiting, should prompt further investigation for other causes (eg, gastroenteritis). (Option B) Elevated blood pressure (≥140/90 mm Hg) is not an expected finding in clients with HG due to dehydration and hypovolemia. Instead, hypotension and tachycardia are expected. (Option C) Proteinuria is not an expected finding in clients with HG but is associated with kidney disease or preeclampsia. Educational objective: Hyperemesis gravidarum (ie, excessive vomiting during pregnancy) leads to fluid and electrolyte imbalances (eg, hypokalemia, hypotension), weight loss of ≥5% of prepregnancy weight, nutritional deficiencies, and ketonuria. Urine ketones are expected because they are a by-product of fat breakdown, which occurs in starvation states.

A Nurse Is Caring for a Client at 12 Weeks