hyperemesis gravidarum Flashcards
what is hyperemesis gravidarum?
severe, deliberating n/v
greater than 5% weight loss in early pregnancy
usually during FIRST TRIMESTER only
cause of HG?
UNKNOWN, believed to be linked to higher than usual chorionic gonadotropin levels (HCG)
symptoms and complications of HG?
dehydration malnutrition (---> wernickes encephalopathy) -metabolic disorders (ketosis) -stress and extreme fatigue -fetal growth restriction -DVT
interventions (holistic/interdisciplinary)
may need to be hospitalized
therapeutic communication and active listening, presence
-reduce odors, noises, fresh air, encourage woman to move slowly
avoid isolation/depression
-monitor weight, electrolytes, nutritional status
treatment for HG
electrolytes, especially Na and K
B1 (thiamine) and b6 (pyridoxine)
MAY require enteral feeding, TPN IN SEVERE cases
medication for HG?
- antiemetics
- folic acid, thiamine
- thiamine
FDA pregnancy risk categories?
tell u if it is ok to use -A= not well enough studied -B= adverse effect -C= risk but benefits may outweigh risk D= DO NOT USE
meds used for HG?
ondansetron dimenhydrinate scopolamine prochlorperazine metoclopramide
contraindications of metoclopramide
- GI obstruction,perforation, hemorrhage
- increase the risk of extra pyramidal reactions so any tardive dyskinesia
diagnosis of HG?
typical presentation with exclusion of other causes
onset of HG?
6-8 weeks, peaks at 12 weeks, relief by 20 weeks but some will have throughout
what causes wernickes encephalopathy?
thiamine deficency, can lead to permanent neurologic dysfunction and death
offspring outcomes from HG?
- small gestational birth weight, preterm
- anomalies, down syndrome, risk for metabolic disease
lifestyle modifications for HG?
dietary and life style
- dry crackers, avoid fatty and spicy foods, seprate eating, high protein meal before getting out of bed
- do not swallow excess saliva
