imbalances stimuli Hyperemesis gravidarum
Transcript of imbalances stimuli Hyperemesis gravidarum
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.