A client is admitted at 18 weeks' gestation with a probable diagnosis of hydatidiform mole
Her signs and symptoms include high-serum human chorionic gonadotropin (HCG) levels, pregnancy-induced hypertension (PIH), uterine enlargement greater than expected for the estimated gestational period, and vaginal bleeding. For the client's nursing diagnosis of Fear related to the possible development of choriocarcinoma, which of these nursing interventions is appropriate? a. Allow the client to express her feelings, and refer her to support sources.
b. Educate the client regarding the need for weekly blood tests for HCG levels.
c. Explain the need for follow-up physical examinations and chest X-rays.
d. Stress the importance of delaying another pregnancy.
A
Hydatidiform mole is an abnormality of the placenta. The chorionic villi become grapelike clusters. There is no viable embryo, but HCG levels are elevated. Classic signs are brownish-colored bleeding, increased uterine enlargement, absence of fetal heart tones, and passing of grapelike clusters. The client must be followed for 1 to 2 years and be tested for serial HCG levels. There is a risk of developing choriocarcinoma, so the client must be frequently evaluated and allow the client to express her feelings, and refer her to support sources.
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