Question

A nurse is providing phone advice for a client who is pregnant

Nurses' Notes
Week 6 of gestation:
Spoke with client over the phone. Client reports nausea and vomiting with a weight loss of 0.9 kg (2 lb) from their pre-pregnancy weight. Client reports no noted change in voiding pattern and denies dry mucus membranes. Advised client to eat small frequent meals of nongreasy, dry, sweet or salty foods, such as dry toast, crackers, and pretzels. Encouraged client to call back if nausea and vomiting worsens.
Week 10 of gestation:
Spoke with client over the phone. Client reports a 6.8 kg (15 lb) weight loss over the past month. Client states nausea continues, making it difficult to eat. They describe a diet of water, toast, and pretzels because other foods are unappealing. They report tolerating a cup of black coffee each morning. Advised client to be seen by the provider today.

Options:

A) Dehydration; persistent nausea and weight loss
B) Hypoglycemia; limited food intake
C) Hyperemesis gravidarum; inability to tolerate other foods
D) Malnutrition; lack of appetite

Answer 1

The client's symptoms of significant nausea, vomiting, and a 6.8 kg weight loss by week 10 of pregnancy are indicative of Hyperemesis gravidarum. This condition is more severe than typical morning sickness and requires medical attention to prevent dehydration and malnutrition.

Step-by-step explanation:

The correct answer to the question regarding the condition suggested by the client's symptoms at week 10 of gestation is Hyperemesis gravidarum; inability to tolerate other foods. The symptoms of significant and persistent nausea, vomiting, and substantial weight loss are consistent with this diagnosis. This condition is more severe than normal morning sickness and can lead to dehydration and malnutrition if not treated.

Nausea and vomiting are common in early pregnancy due to hormonal changes, but usually subside by about week 12. When the symptoms are severe and lead to weight loss, as described by the client, the condition of Hyperemesis gravidarum should be considered. Early intervention is crucial as prolonged vomiting can lead to dehydration, electrolyte imbalances, and nutritional deficiencies. Encouraging small, frequent meals and hydration is good initial advice, but medical evaluation is essential.