Hyperemesis gravidarum is extreme morning sickness that causes long-lasting intense nausea, vomiting and weight loss. While many pregnant women experience morning sickness, hyperemesis gravidarum develops between the 4th – 6th weeks of pregnancy and may last longer than week 20. Symptoms may be so severe that they interrupt the patient’s daily activities.
While the exact cause is still unknown, many believe hyperemesis gravidarum is caused by a rapid rise in hormone (hCg) levels. This condition may last several weeks or throughout the majority of the pregnancy. Complications that may arise from excessive vomiting include dehydration, renal impairment, malnutrition and electrolyte imbalance.
Reduce and manage symptoms of nausea and vomiting; maintain appropriate nutrition and hydration; avoid complications and injury to patient and fetus
Note vital signs to get a baseline
Fluid loss from vomiting and inability to tolerate oral fluids may result in dehydration.
Monitor labs to determine if patient has electrolyte imbalance or renal impairment from excessive vomiting.
Monitor urine and emesis for blood; also note dark urine and decreased output that indicate renal function impairment
Patients often lose approx 5% of their weight. Monitor weight to ensure interventions are effective.
Excessive vomiting and food/smell aversions make it difficult to maintain proper nutrition and tube feedings may be necessary to provide adequate nutrition for patient and fetus.
Avoid known triggers such as foods or smells. Take note of offending hygiene products and offer alternatives. Toothpaste is often a trigger.
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