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.

Complete the following sentence by using the lists of options.

"The client is at risk for experiencing ___________________ (a miscarriage/ metabolic acidosis) due to the client's ___________________ (weight loss/dehydration)."

Option 1: a miscarriage / weight loss
Option 2: a miscarriage / dehydration
Option 3: metabolic acidosis / weight loss
Option 4: metabolic acidosis / dehydration

Answer 1

The pregnant client is at risk for metabolic acidosis due to significant weight loss resulting from severe morning sickness, not dehydration, since the client does not exhibit symptoms of dehydration.

Step-by-step explanation:

The client described in the Nurses' Notes is at risk for experiencing metabolic acidosis due to the client's weight loss. The significant weight loss of 6.8 kg (15 lb) over the past month, along with persistent nausea and difficulty eating, suggests the client may be experiencing severe morning sickness, leading to inadequate nutrition and potential electrolyte imbalances that could result in metabolic acidosis. Given that the client does not report symptoms such as dry mucus membranes, which might indicate dehydration, weight loss stands out as the primary concern related to metabolic acidosis risk.