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
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
... Through the demonstration of these values on a daily basis, the nurse is able to not only take better care of his or her patients, but is also able to take care of his or herself. Through self-care, the nurse is able to better understand the phenomena of the client, and is able to provide better client-centered care.
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.
... M.A. (2006). Applications of Dorthea Orem's self care deficit nursing theory. In M.E. Parker (Ed.) (2006). Nursing theory and nursing practice (2nd ed., pp. 149-155). Philadelphia: EA. Davis Company.
Something that occurs when pregnant, severe vomiting and nausea that leads to dehydration and weight loss.
Dehydration is not just something that stays for a few hours and then goes away. Without the proper amounts of liquid in your body, you can’t function properly. If dehydration is ignored and is prolonged for awhile, it can have significant effects on your body. Severe dehydration that has lasted for a long time can have symptoms that include: not having to pee or having dark yellow pee, flaky, dry skin, dizziness, rapid heartbeat and breathing, sunken in eyes, fatigue, confusion, easily irritated, lack of energy, and fainting or blackouts. In very serious cases, severe dehydration can be
MUST is a five-step screening tool designed for healthcare professionals to identify adult patients who at risk of, or are malnourished. It includes guidelines on how to develop an effective treatment plan. The Malnutrition Advisory Group (MAG) in 2000 adapted and extended their community screening tool to include care homes and hospitals, in response to national concerns. (Department of Health, 2001). In 2003 MUST was designed by MAG and the British Association for Parenteral and Enteral Nutrition (BAPEN). It was piloted across many care settings, to target patients who may be at risk of malnutrition.
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.
Jean E. Johnson (1997), a registered nurse and graduate professor at the University of Rochester School of Nursing, is considered responsible for developing the Self-Regulation Theory (SRT) in the late nineteen nineties. It was through years of contributions and interactions with her professional colleagues, students, and attendees of her “Stress and Coping” group that contributed to the development of this theory. It was identified, and holds true today, that patients are expected to play an ...
I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care, self-care deficit, and nursing systems. (Parker & Smith 2010). Orem defines self-care as when an individual initiates activities and performs to maintain life, health and well-being on their own and self-care deficit as not meeting adequate self-care requisites which include “limitations for knowing, deciding and producing care to self or dependent. (Parker & Smith, 2010)
... family members on the dangers of GAS and other microbial infection during and after pregnancy.
Nutrition assessments include clinical and dietary assessment, anthropometrics, as well as biochemical, laboratory immunologic and functional indices of nutritional status (Gibney, 2005). In epidemiological studies, different dietary investigation tools were designed to assess the nutritional status in individuals and populations, nutrition monitoring and surveillance and diet-disease research (Friedenreich, et al., 1992, Taren, 2002).
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.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).
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.