Hyperemesis gravidarum is vomiting during pregnancy that is so severe it leads to dehydration, electrolyte and acid–base imbalance, and starvation ketosis. It appears to be related to rising chorionic gonadotropin and/or estrogen levels. Other factors may include a psychological component related to ambivalence about the pregnancy, but this is controversial .Regardless of the cause, a woman experiencing hyperemesis presents in the clinical situation severely dehydrated and physically and emotionally debilitated,
- Vomiting that may be prolonged, frequent, and severe
- Weight loss, acetonuria, and ketosis (Losing More than 10 pound of body weight)
- Signs and symptoms of dehydration including;
- Dry mucous membranes
- Poor skin turgor
- Low blood pressure
- Loos of Appetite
- Disturbance in sleep
- Dysgeusia- also known as parageusia, is a distortion of the sense of taste.
- Mood change
- Decrease in concentration
- Decrease in gustatory discernment
- Feeling irritated
Risk for Hyperemesis Gravidarum-
- History of HCG in family
- First- time mother
- Pregnant with more than one baby
- Vitamin B6 and antiemetics for treatment of nausea and vomiting
- IV hydration for fluid, electrolytes, and vitamin replacement
- Laboratory studies to monitor kidney and liver function
- Assess factors that contribute to nausea and vomiting.
- Reduce or eliminate factors that contribute to nausea and vomiting such as eliminating odors.
- Provide emotional support.
- Provide comfort measures such as good oral hygiene.
- Provide IV hydration, electrolytes, and antiemetics as per orders.
- Check weight daily.
- Facilitate nutritional and dietary consult.
- Determine the woman’s food preferences and provide them.
- Minimizing fluid intake with meals can decrease nausea and vomiting.
- Monitor I&O and specific gravity of urine to monitor hydration.
- Monitor nausea and vomiting.
- Monitor laboratory values for fluid and electrolyte imbalances.
- Ensure that the woman remains NPO until vomiting is controlled, then slowly advance the diet as tolerated.