What is a priority nursing consideration for a patient with hyperemesis gravidarum?

Treatment and Medication Options for Hyperemesis Gravidarum

If you have severe symptoms of hyperemesis gravidarum, you may need to be hospitalized. According to the National Organization for Rare Disorders, hyperemesis gravidarum is the second leading cause of hospitalization in early pregnancy.

For less severe cases, you may be able to seek treatment at home or at a doctor's office.

While the course of treatment for hyperemesis gravidarum varies from person to person, your doctor may recommend one or more of the following:

  • Vitamin B6
  • Small, frequent meals that include dry, bland foods such as crackers
  • Intravenous fluids to help with dehydration
  • For severe cases, parenteral nutrition, in which an intravenous (IV) solution of vitamins and nutrients is given as a substitute for food

Medication Options

RELATED:8 Surprising Health Benefits of B Vitamins

Alternative and Complementary Therapies

Evidence concerning the effectiveness of the following therapies for hyperemesis gravidarum remains inconclusive. But when used in addition to traditional medical interventions, they may help alleviate symptoms. They include:

  • Acupuncture and acupressure
  • Hypnosis
  • Light therapy (to help with depression)

Ginger, whether taken in tea or through a capsule, is also thought to be helpful.

Before trying any of the above, make sure to discuss their use with your healthcare provider.

Prevention of Hyperemesis Gravidarum

While there's no way to completely prevent hyperemesis gravidarum, Harvard Health Publishing notes that women who take a multivitamin before getting pregnant, such as a prenatal vitamin, are less prone to severe symptoms.

If morning sickness develops during pregnancy, you may reduce the severity and duration of symptoms by eating small, frequent meals of bland foods rather than spicy ones, waiting to take any iron supplements until the nausea has passed, and, on your doctor's recommendation, trying acupressure, vitamin B6, or ginger.

Basic Concepts of Nursing

Assessment of Hyperemesis Gravidarum

a. Activity / rest

  • Decreased systolic blood pressure, increased pulse rate (> 100 beats per minute).

b. Ego integrity

  • Family interpersonal conflict, economic hardship, change perceptions about conditions, unplanned pregnancies.

c. Elimination

  • Changes in consistency; defecation, increased frequency of urination, Urinalysis: increased concentration of urine.

d. Food / fluid

  • Excessive nausea and vomiting (4-8 weeks), epigastric pain, weight loss (5-10 kg), oral mucous membrane irritation and red, low hemoglobin and hematocrit, breath smelling of acetone, reduced skin turgor, sunken eyes and dry tongue .

e. Eespiratory

  • Increased respiratory rate.

f. Security

  • Temperature sometimes rose, weakness, icterus and can fall into a coma

g. Se.uality

  • Cessation of menstruation, when the state of the mother harm done therapeutic abortion.

h. Social interaction

  • Changes in health status / stressors of pregnancy, changes in roles, family members response can vary to hospitalization and illness, lack of support system.

i. Learning and education

  • Everything is eaten and drunk vomited, especially if lasts long apalahi
  • Weight loss of more than 1/10 of the normal body berast
  • Skin turgor, dry tongue
  • The presence of acetone in the urine.

j. Diagnostic tests

  • Ultrasound (using the appropriate time): assessment of the gestational age of the fetus and the presence of multiple gestation, fetal abnormality detecting, localizing the placenta.
  • Urinalysis: culture, bacterial detection, BUN.
  • Liver function tests: AST, ALT and LDH levels.

Nursing Diagnosis for Hyperemesis Gravidarum

1. Imbalanced Nutrition, Less Than Body Requirements related to the frequency of excessive nausea and vomiting.
2. Fluid Volume Deficit related to excessive fluid loss.
3. Anxiety related to ineffective coping, physiological changes of pregnancy.
4. Activity intolerance related to weakness.

Nursing Interventions for Hyperemesis Gravidarum

1. Imbalanced Nutrition, Less Than Body Requirements related to the frequency of excessive nausea and vomiting.

Interventions:

  • Limit oral intake until the vomiting stops.
  • Give anti-emetic drugs are programmed with a low dose.
  • Maintain fluid therapy programmed.
  • Record intake and output.
  • Encourage eating in small portions but frequently.
  • Instruct to avoid fatty foods.
  • Instruct to eat a snack such as biscuit, bread and the (hot) warm before bed get up during the day and before bed.
  • Catal intake, if oral intake can not be given within a certain period.
  • Inspection Iesi irritation or mouth.
  • Assess oral hygiene and personal hygiene as well as the use of oral cleaning fluids as often as possible.
  • Monitor hemoglobin levels and Hemotokrit
  • Urine Test against acetone, albumin and glucose.
  • Measure uterine enlargement.

Rational:

  • Maintain fluid electrolyte balance and prevent further vomiting.
  • Prevent vomiting and maintaining fluid and electrolyte balance.
  • Correction presence of hypovolemia and electrolyte balance.
  • Determining hydration fluids and spending synthetically by vomiting.
  • Be sufficient intake of nutrients your body needs.
  • To stimulate nausea and vomiting.
  • Snack can reduce or avoid excessive excitatory nausea vomiting.
  • To maintain a balance of nutrients.
  • To determine the integrity inukosa mouth.
  • To maintain the integrity of the oral mucosa.
  • Identifying the presence of anemia and the potential reduction in the oxygen-carrying capacity of the mother. Clients with hemoglobin levels less than 12 g / dl or hematocrit levels less than 37% considered anemic in the first trimester.
  • Establish a baseline; done routinely to detect potential high-risk situations such as the inadequate intake of carbohydrates, Diabetic ketoacidosis and hypertension due to pregnancy.
  • Maternal malnutrition affect fetal growth and aggravate the decline in the complement of brain cells in the fetus, resulting in fetal development setbacks and further possibilities.

2. Fluid Volume Deficit related to excessive fluid loss.

Interventions :

  • Determine the frequency or severity of nausea / vomiting.
  • Review the history of the possibility of other medical problems (such as peptic ulcer, gastritis).
  • Assess body temperature and skin turgor, mucous membranes, blood pressure, input / output and urine specific gravity. Measure weight and compare it with the standard.
  • Encourage increased intake of carbonated drinks, eat as often as possible with the least amount. Foods high in carbonates such as: dry toast before getting up from bed.

Rational:

  • Provide data with respect to all conditions. Elevated levels of chorionic gonadotropin hormone (HCG), changes in carbohydrate metabolism and decreased gastric motility aggravate nausea / vomiting trimester.
  • Assist in other causes aside to address specific problems in identifying interventions.
  • As an indicator of the level or need help evaluating hydration.
  • Assist in minimizing nausea / vomiting by reducing gastric acidity.

3. Anxiety related to ineffective coping, physiological changes of pregnancy.

Interventions:

  • Control of the client environment and limit visitors.
  • Assess the client's level of psychological functioning.
  • Provide psychological support.
  • Give positive reinforcement.
  • Give maximum health.

Rational:

  • To prevent and reduce anxiety.
  • To maintain psychological integrity.
  • To reduce anxiety and foster mutual trust.
  • To alleviate the psychological effect due to pregnancy.
  • It is important for improving the mental health of the client.

4. Activity intolerance related to weakness.

Interventions:

  • Encourage clients to restrict the activities of the isrirahat enough.
  • Encourage clients to avoid heavy lifting.
  • Help clients activities gradually.
  • Encourage bed rest were modified as indicated.

Rational:

  • Save energy and avoid spending power continuously to minimize fatigue / sensitivity of the uterus.
  • Previously tolerated activity may not be modified for women at risk.
  • Activity gradually minimize trauma Seita ease in meeting their needs.
  • Periu activity levels may be modified as indicated.

Nursing Care Plan for Hyperemesis Gravidarum

What are the priority interventions for a patient presenting with hyperemesis gravidarum?

Nursing Management.
Make sure that the client is NPO until cessation of vomiting..
Administer intravenous fluids as prescribed; they may be given on an ambulatory basis when dehydration is mild..
Measure and record fluid intake and output..
Encourage small frequent meals and snacks once vomiting has subsided..

What is the nursing intervention for hyperemesis gravidarum?

Encourage the patient to eat, and tell her to avoid going for a long period without eating. Advise her to eat when she feels hungry, starting with small, frequent lowfat meals. She should avoid drinking fluids with meals. Antiemetics may be used with I.V.

What are priority nursing considerations?

These include: the expertise of the nurse; the patient's condition; the availability of resources; ward organization; philosophies and models of care; the nurse-patient relationship; and the cognitive strategy used by the nurse to set priorities.

What are monitored in a patient with hyperemesis gravidarum?

Hyperemesis gravidarum is severe nausea and vomiting during pregnancy that results in dehydration, weight loss, and ketosis. Diagnosis is clinical and by measurement of urine ketones, serum electrolytes, and renal function.