The nurse has reviewed the Vital Signs, Nurses' Notes, and Provider Notes from 1 week ago. A nurse on an antepartum unit is planning care for the client. For each potential intervention, click to specify if the intervention is expected or unexpected for the client. There must be at least 1 selection in every row, There does not need to be a selection in every column.

Rationale: • Administer lactated Ringer’s: The client is experiencing hyperemesis gravidarum with persistent vomiting and signs of dehydration, including dark, concentrated urine and hypotension. IV fluid replacement with lactated Ringer’s is appropriate to restore fluid and electrolyte balance. • Initiate NPO status: NPO (nothing by mouth) status may be implemented temporarily to rest the gastrointestinal tract, especially if severe nausea and vomiting prevent adequate oral intake. This allows safe administration of IV fluids and antiemetic medications. • Measure intake and output: Monitoring intake and output provides objective data to assess hydration status, fluid balance, and response to therapy. Accurate measurement helps guide fluid replacement and detect ongoing losses. • Administer terbutaline: Terbutaline is a beta-agonist used primarily for preterm labor to relax the uterus. It is unrelated to hyperemesis gravidarum and would not be indicated in this scenario. Administering terbutaline could pose unnecessary maternal and fetal risks. • Administer metoclopramide: Metoclopramide is a prokinetic antiemetic commonly used in hyperemesis gravidarum to reduce nausea and vomiting. Administering this medication under provider orders supports oral intake and prevents further dehydration and electrolyte imbalance.