A client in the 13th week of pregnancy develops hyperemesis gravidarum. Which laboratory finding indicates the need for intervention?

• A. Elevated hCG levels.
• B. Decreased serum potassium.
• C. Ketones in urine.
• D. Low hematocrit.

Answer: (C)

When vomiting is severe in early pregnancy, the body can fall into a state of dehydration and energy deficit. Ketones in the urine mean the body is breaking down fat for energy because there isn’t enough carbohydrate intake, signaling a significant caloric deficit that requires medical intervention. This points to the need for fluids, electrolyte correction, and nutritional support to prevent maternal and fetal complications.

Elevated hCG is a normal finding in early pregnancy and doesn’t by itself indicate the need for intervention. A low hematocrit can reflect dehydration or anemia but isn’t as direct a marker of acute nutritional compromise as ketonuria. While potassium may drop with vomiting, the presence of ketones specifically demonstrates that the patient is in ketosis and needs treatment now.