Module 8 (Exam 3) Independent Study 1

Question 1

Hyperemesis Gravidarum

Answer 1

Persistent, unremitting nausea and vomiting of pregnancy (NVP) beginning prior to the 20th gestational week

Question 2

Consequences of Hyperemesis Gravidarum

Answer 2

1. Dehydration
2. Weight loss
3. Electrolyte imbalance
4. Acid-base imbalance
   
   1. Initial alkalosis (loss of hydrochloric acid)
   2. Subsequent acidosis (starvation, loss of intestinal secretions)

Question 3

Etiology of hyperemesis gravidarum

Answer 3

1. Hormonal influence (rapidly rising hCG and estrogen levels)
2. Sensitivity to fetal proteins
3. Thyroid dysfunction
4. Interaction of physiologic and psychologic factors
   
   1. Patients’ assessment of severity of symptoms
   2. Care providers’ acceptance of symptomatology

Question 4

At home management of hyperemesis gravidarum

Answer 4

1. Adequate hydration
2. Small, frequent meals
3. Avoidance of high fat foods
4. Increased protein, complex carbohydrates
5. Attention to sodium, potassium and magnesium intake
6. Maternal and fetal surveillance

Question 5

What potassium rich foods should be encouraged?

Answer 5

Fruits and veggies and meats

Question 6

What magnesium rich food sources should be encouraged?

Answer 6

seeds, nuts, legumes, green veggies

Question 7

Hospital management of hyperemesis gravidarum

Answer 7

1. IV fluid and electrolyte replacement
2. Strict I&O
3. TPN when indicated
4. NPO 24-48 hours
5. PO resumption, clear liquids to small, frequent meals
6. Emotional and social support

Question 8

Chemical management of hyperemesis gravidarum

Answer 8

1. First Line: antihistamines (Doxylamine), Vitamin B6 (Pyridoxine), Antacids (H2 blockers), Phenothiazines
2. Metoclopramide (Reglan)
3. Ondansetron (Zofran)