Hyperemesis Gravidarum
Brooke Larsen
City College at Montana State University Billings
Hyperemesis Gravidarum
Nausea and vomiting are especially common during early pregnancy, particularly within the first trimester. Most women experience nausea and vomiting, commonly referred to as “morning sickness”, which is often attributed to the mother’s reaction to the spike in pregnancy hormones. Although feeling ill is considered normal within the first few months of pregnancy, there are instances of nausea and vomiting that continue on to the second and third trimesters and are then considered more severe. When dehydration, electrolyte imbalances, weight loss, acidosis, or even hepatic and renal damage occur as a result of the hyperemesis, it is then determined to be hyperemesis gravidarum.
“Hyperemesis gravidarum is a relatively rare coniditon, occurring in about 0.3% to 2% of all pregnancies” (Davidson, London, &Ladewig, 2012). It is described as a condition in which nausea and vomiting are so severe that they affect both the mother’s nutritional and hydration status. It is still unknown what specifically causes hyperemesis gravidarum, but it is suggested that the levels of hCG and other pregnancy hormones play a role. Signs and symptoms that the illness is in fact hyperemesis gravidarum, and not just “morning sickness”, include not being able to keep any food down, lightheadedness or fainting, electrolyte imbalances, weight loss, and dehydration. According to Davidson, London, and Ladwig, “The diagnostic criteria for hyperemesis include a history of intractable vomiting in the first half of pregnancy, dehydration, ketonuria, and a weight loss of 5% of prepregnancy weight” (Davidson, London, & Ladewig, ...
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...electrolytes.
Rationale: These laboratory test results have been shown to be fair indicators of malnutrition. Ackley and Ladwig p. 576
2. Compromised family coping related to shift in health status of family member.
Intervention: Serve as an advocate, mentor, and role model for caregiving.
Rationale: Therapeutic use of self by the nurse and concrete task definition and assignment reinforce positive coping strategies and allow caregivers to feel less guilty when tasks are delegated to multiple caregivers. Ackley and Ladwig p. 286
3. Risk for electrolyte imbalance related to dehydration.
Intervention: Teach client and family members the warning signs of dehydration,
Rationale: Early signs of dehydration include thirst and cessation of perspiration, muscle cramps, nausea and vomiting, lightheadedness, and orthostatic hypotension. Ackley and Ladwig p. 345
Gale Group. (2013, May). Maternal Complications from Placenta Previa. Retrieved May 06, 2013, from Galenet: http://140.234.20.9:8080/EPSessionID=838ee1ba12d4ed675b34eeada9e17bc/EPHost=galenet.galegroup.com/EPPath/servlet/HWRC/hits?docNum=A246374229&index3=KE&index2=KE&index1=FT&tcit=0_1_0_0_0_1&locID=lac73470&rlt=6&text3=&text2=&origSearch=false&text1=maternal+
These women could anticipate delays in normal growth and development for the fetus. The exact cause of post term pregnancy is unknown. The mother experiencing post term pregnancy is at risk for trauma, hemorrhage, infection, and labor abnormalities (Ward et al., 2016, p. 543). Labor induction prior to 42 weeks’ gestation prevents MAS and other complications. A biophysical profile measuring the heart rate, breathing and body movements, tone, and the amniotic fluid volume is used to monitor the fetus for intrapartum fetal stress that could cause passage of meconium. Diabetic woman is at high risk for preeclampsia or eclampsia, infection, hydramnios, postpartum hemorrhage, and cesarean birth (Ward et al., 2016, p. 383). In addition, fetal macrosomia prolongs labor due to shoulder dystocia. The glucose challenge test, and the 3- hour OGTT is used for gestational diabetes screening, done after 24 weeks of pregnancy. Abnormalities of the respiratory system as explained earlier are the most concerning complication of MAS, needing immediate
1. Preeclampsia. Women with this condition have high blood pressure during pregnancy, accompanied by water retention and protein in their urine. It can lead to complications including babies with low birth weight. However, if diagnosed and treated early, affected women can deliver normal babies. Treatment includes consuming a healthy, low salt diet and engaging in regular exercsie as recommended.
Self-care has a very different meaning for people. It varies from person to person and can be based on age, gender, religion, occupation, and their type of lifestyle that they live. For myself, my self-care has changed since starting nursing school and I now know have to look at it in terms of nursing. Although my self-care has not changed substantially I now have to realize that being a nurse, I will have more responsibility’s and will be taking care of others and I cannot take care of others until I take care of myself. Self-care is very important for many reasons; in my opinion a healthy person in mind, body and soul is a happy person. You cannot take care of others if you yourself are not healthy and happy.
Pregnant women have to be careful while pregnant. They have to watch out for various speed bumps. There are tons of toxins that can hurt the baby in the womb. The mother is responsible for most of these, after all she is the one who is carrying the baby. Many of these factors can result in death. It is really sad that it has to end that way some of the time. The worst toxins for a baby to encounter while in the mother’s uterus are different types of drugs and alcohol. Those two things can could serious problems for the infant once it gets into their system. They enter into the baby’s bloodstream from the mother, and cause problems from there on out.
Substance abuse during pregnancy can have a negative force on the health and wellness of not only the fetus, but that of the mother. The harmful effects of medications, alcohol and illegal drugs on an unborn child can be devastating and can have significant consequences to its use. Sometimes the effects can be faced and treated, and other times the outcome is a lifelong challenge. During the prenatal period, it is important that new mothers are informed of the different types of abuse, how they may affect the fetus, and the adverse conditions their child may be faced with before and after birth.
...n level in the blood which is hyperbilirubinemia. The woman’s baby may be at risk for also developing diabetes and obesity. If you have had gestational diabetes you are at a higher risk for developing it again during future pregnancies.
Something that occurs when pregnant, severe vomiting and nausea that leads to dehydration and weight loss.
It is crucial for a woman to maintain a good health throughout the whole pregnancy stage. Not only for her sake but also for the well-being of the yet to be born baby. Anything that is consumed during a pregnancy will affect both the mother and the growing fetus (child). Once a woman gets pregnant it is recommended that she changes her eating habits, exercise, the regular visit to the doctor office and make the changes that are needed for a healthy pregnancy. Most importantly, a pregnant woman should always avoid substances abuse because of the threat that they pose.
Nursing theory is best described as a conceptualization of some aspect of nursing communicated for the purpose of describing, explaining, predicting, and/or prescribing nursing care (Potter & Perry, 2009). One of the most world renown-nursing theorists, Dorothea Orem, believed in the self-care theory, which directs it’s attention on the aspect the self-care needs of the client (2009). As a registered nurse, along with many other accomplishments, she began brewing her theory that guided many nursing schools/institutions in their program of studies. As a nurse, she felt it was necessary to do the things for patients they could not do on their own (Tiaki, 2008). Tiaki feels Orem’s theory is efficient because this theory will help patients to learn the tasks they are unable to do from the nurses, teaching them how to care for themselves (2008). The purpose of this paper is to describe Orem’s historical background, describe her self-care theory, and describe how her theory can be applied into nursing today.
... family members on the dangers of GAS and other microbial infection during and after pregnancy.
According to a research article by Lee and Saha (2013), 70 to 80 percent of all pregnant women experience nausea and vomiting. Nausea and vomiting during pregnancy is believed to be caused by rapidly rising serum levels of the hormones human chorionic gonadotropin (HCG) and estrogen (Cleveland Clinic, 2012). However, when nausea and vomiting becomes severe to the point that it can cause electrolyte imbalances, weight loss, and dehydration (Cleveland Clinic, 2012), then it becomes a disorder called Hyperemesis Gravidarum (Lee & Saha, 2013). The Cleveland Clinic (2012) describes Hyperemesis Gravidarum as “an uncommon disorder in which extreme, persistent nausea and vomiting occur during pregnancy.”
During the pregnancy my mother had various cravings. The most common food craving she had was lemon and chili powder. To satisfied her cravings she added lemon and chili to almost all her food. She craved chili and lemon because she felt the need of eating sour and salty food. In the article “Craving During Pregnancy” the unknown author states, "There also is an interesting theory out there that says because a woman's blood volume increases during pregnancy the amount of sodium is lower in the body and that's why they crave salt” (“Craving During Pregnancy”, n.d.).While being pregnant she also enjoyed eating fruit flavored popsicles. Another of her cravings was cafe which was weird because she would not drink it before her pregnancy. One of the most unusual craving she had was mud because of the smell of the wet ground. Even though she craved it she never eat it
Another cause of dehydration can occur if you experience a period of vomiting or diarrhea (http://www.nlm.nih.gov/medlineplus/ency/article/000982.htm). Since you loose so many liquids when you are vomiting, your stomach doesn’t feel like eating or drinking
Chambers, C. D., Polifka, J. E., & Friedman, J. M. (2008). Drug safety in pregnant women and their babies: ignorance not bliss. Clinical Pharmacology & Therapeutics, 83(1), 181-183.