Hyperemesis gravidarum What is it?

Excessive vomiting that leads to dehydration, starvation, and even death among pregnant populationsRelated to increased estrogen levels

Assessment ❖ Hypotension ❖ Elevated H&H❖ Decreased urine

output ❖ Hypokalemia ❖ Weight loss❖ Ketonuria

Interventions ❖ 48 hours of NPO status ❖ IV fluids❖ Antiemetics as ordered❖ Vitamins ❖ Decrease environmental

stimuli❖ Clear liquids and small dry

feedings as tolerated. ❖ Give either cold or hot food,

nothing room temp.

Critical labs ❖ Potassium❖ Have the patient on tele❖ Monitor for symptoms of

shock and fluid volume deficit.

Complications ❖ Dehydration ❖ Wernicke's encephalopathy from

vitamin B1 deficiency ❖ Mallory-Weiss tears (esophageal

tears and bleeding) ❖ Esophageal bleeding ❖ Pneumothorax ❖ Acute tubular necrosis ❖ Electrolyte and acid‑base

imbalances

Diagnostic studies ❖ Potassium, sodium, chloride, and protein levels

are decreased due to losses from vomiting. ❖ Blood urea nitrogen, non protein nitrogen, and

uric acid levels are increased due to renal compromise and hemoconcentration. Hemoglobin (Hb) level and hematocrit (HCT) are increased due to hemoconcentration.

❖ Urinalysis reveals ketones and, possibly, protein; urine specific gravity increases.

❖ Vitamin B1 and B6 levels are decreased due to impaired intake.

❖ Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels may be mildly increased.