Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that leads to dehydration, weight loss, electrolyte imbalance, and nutritional deficiency. Unlike normal morning sickness, it is persistent and may require hospitalization.
Causes and Risk Factors
The exact cause is unknown, but hyperemesis gravidarum is associated with hormonal, metabolic, gastrointestinal, and psychological factors.
Hormonal Factors
- Elevated hCG levels
- High estrogen levels
- Thyroid hormone changes
Risk Factors
- First pregnancy
- Multiple gestation
- Family history of HG
- History of HG in previous pregnancies
Signs and Symptoms
- Persistent nausea and vomiting
- Dehydration
- Weight loss
- Ketonuria
- Electrolyte imbalance
- Dizziness and fatigue
Complications
- Severe dehydration
- Electrolyte imbalance
- Wernicke’s encephalopathy
- Low birth weight
- Preterm birth
Nursing Diagnoses
1. Imbalanced Nutrition: Less Than Body Requirements
Related to frequent nausea and vomiting, inability to tolerate food or fluids.
- Monitor weight and electrolytes
- Offer small, frequent meals
- Provide antiemetics as prescribed
- Encourage vitamin B6 and B1 supplements
2. Fluid Volume Deficit
Related to excessive fluid loss due to vomiting.
- Administer IV fluids as ordered
- Monitor intake and output
- Check mucous membranes and skin turgor
- Encourage oral hydration when tolerated
3. Ineffective Coping
Related to emotional stress of persistent symptoms.
- Provide emotional support
- Educate about the condition
- Teach relaxation techniques
4. Activity Intolerance
Related to weakness and fatigue.
- Encourage rest
- Assist with daily activities
- Monitor vital signs and endurance
Conclusion
Hyperemesis gravidarum requires comprehensive nursing care to prevent dehydration, malnutrition, and complications. With proper management, patients typically recover and continue a healthy pregnancy.
Sources
- ACOG Practice Bulletin – Nausea and Vomiting of Pregnancy
- MedlinePlus – Hyperemesis Gravidarum
- WHO Maternal Health Guidelines
