imbalances stimuli hyperemesis gravidarum
TRANSCRIPT
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.