GROUP #8

Hyperemesis
Gravidarum
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Hyperemesis
Gravidarum
Is extreme, persistent nausea and
vomiting during pregnancy. It can lead
to dehydration, weight loss and
electrolyte imbalances.
 SIGNS AND SYMPTOMS

The symptoms can be severely uncomfortable.

Dehydration including feeling thirsty, tired,
dizzy or light headed, not peeing very much and
having dark yellow and strong-smelling urine.
 Diagnostic & Laboratory Test

Laboratory testing may include the following:

Obtaining electrolyte, BUN and creatinine, and
serum ketone levels. Measuring urine gravity and
ketones.
 Risk Factors

The risk factors for developing hyperemesis

gravidarum include:

•First pregnancy
•Previous history of hyperemesis gravidarum
•Raised BMI
•Multiple pregnancy
•Hydatidiform mole
 Nursing Diagnosis

The priority of nursing care for patients with

hyperemesis gravidarum is to identify the:
•Severity of nausea and vomiting,
•The degree of dehydration,
•And the extent of the weight loss.
 Nursing Diagnosis

Assess for possible causes and triggers of

nausea aside from pregnancy.

- Proper assessment of the triggers and causes of

nausea can help plan an appropriate treatment
regimen, preventing the condition from
becoming severe.
 Nursing Diagnosis

Assess for a history of nausea.

- Research shows that women who experience

nausea and vomiting outside of pregnancy, such
as due to motion sickness or migraine
headaches, are at a higher risk of experiencing
nausea and vomiting during pregnancy.
 Interventions:

with strong and
Eliminate objects or food
unpleasant odors.

- Pregnancy can cause odor sensitivity, which

may trigger nausea and vomiting. Strong and
unpleasant odors can exacerbate hyperemesis
gravidarum.
 Interventions:

Administer antiemetics as indicated.

Antiemetics may be provided to pregnant

women with hyperemesis gravidarum to help
alleviate nausea and vomiting.
 Nursing Diagnosis

Monitor intake and output.

- Patients with hyperemesis gravidarum often are

unable to keep any food down. Strict monitoring
of intake (oral or IV) and output (vomiting, urine)
is required as dehydration can occur quickly.
 Nursing Diagnosis

Assess for any signs of dehydration.

Signs of dehydration like dry skin, dry mucous

membranes, poor skin turgor, reduced blood
pressure, tachycardia, and fever can result from
excessive nausea and vomiting.
 Interventions:

Evaluate and monitor laboratory values.

- With excessive and prolonged vomiting, fluid

loss and electrolyte imbalances occur. When
potassium and magnesium are low,
complications such as cardiac dysrhythmias and
altered kidney function can occur.
 Interventions:

Administer intravenous fluid replacement as ordered.

- Intravenous fluid replacement can help manage

fluid loss, prevent dehydration, and correct
electrolyte imbalances in patients with
hyperemesis gravidarum.
 Nursing Diagnosis

Assess the
fetus.

- If inpatient management is required, continuous

fetal monitoring may be recommended to
monitor the fetal heart rate.
 Nursing Diagnosis

Assess and monitor maternal weight.

- Severe and prolonged nausea and

vomiting can cause malnutrition,
dehydration, and weight loss. A weight
loss of 5% of the pre-pregnancy weight
is a common finding to support
hyperemesis gravidarum.
 Interventions:

Administer parenteral nutrition as indicated.

- Administration of parenteral nutrition

may be required for patients with
hyperemesis gravidarum who cannot
tolerate foods and fluid intake.
 Interventions:

Encourage small meals.

- Small meals allow food intake without aggravating

bouts of nausea and vomiting.

Offer ginger or change prenatal vitamins as ordered.

- Switching the mother’s prenatal vitamins to folic acid
alone may help. Ginger chews or drinks can also help
relieve nausea.
 Medical/ Surgical Management

Treatment methods include a range of options,

including maternal diet and lifestyle
alterations, administration of intravenous
fluids, antiemetics or steroids, and alternative
therapies such as acupuncture and hypnosis.
Drug Analysis
 Drug Analysis

Nursing Responsibility
• Learn rich dietary sources of vitamin B6:
• Monitor neurologic status

to determine therapeutic Yeast, Wheat germ, Whole grain cereals,

effect in deficiency states.
• Observe for Improvement of
deficiency symptoms, glossitis.
• Evaluate for nutritional adequacy.
Meat (Liver), Legumes, Green vegetables
and Bananas
• Lab tests: Periodic Hct and Hgb and
serum iron.

• Record a complete dietary history so poor eating habits can be

identified and corrected (a single vitamin deficiency is rare;
patient can be expected to have multiple vitamins deficiencies.)
Pathophysiology
HYPEREMESIS GRAVIDARUM

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GROUP #8