Introduction
Hyperemesis gravidarum is a specific condition associated with pregnancy that is characterized by nausea and vomiting observed in pregnant women. However, not all cases of nausea and vomiting can be diagnosed as hyperemesis gravidarum because of its severe form. In spite of the fact that nausea and associated signs are typical of “50% to 90% of pregnant women,” the cases of hyperemesis gravidarum are rare, and this condition is diagnosed only in “0.3% to 2.0% of pregnancies” (Nayeri, 2012, p. 22). Hyperemesis gravidarum affects all aspects of a pregnant woman’s life, and much attention should be paid to examining the impact of this state on a woman and a fetus. The purpose of this paper is to discuss hyperemesis gravidarum with the focus on its signs, describe the possible treatment and nurses’ actions, focus on the patient education, and concentrate on the possible effects that the state has on a woman and a fetus.
Definition of Hyperemesis Gravidarum
Physicians and nurses experience certain problems with defining hyperemesis gravidarum because this condition is discussed as the extreme form of nausea and vomiting typical of pregnancy, but there are differences in individuals regarding the severity of the state (Duman, Ozcan, & Bostanci, 2015). Hyperemesis gravidarum is usually defined as a complication of pregnancy that is characterized by extreme sickness and uncontrolled vomiting (Bolin, Akerud, Cnattingius, Stephansson, & Wikstrom, 2013). A woman having hyperemesis usually suffers from dehydration, the weight loss, the imbalance of electrolytes, and ketonuria among other complications. Women who have such symptoms require hospitalization and treatment (Nayeri, 2012). The problem is in the fact that it is rather difficult to determine causes of hyperemesis gravidarum, and the condition is associated with imbalances in hormone levels, fetal anomalies, and women’s psychological problems.
Symptoms of Hyperemesis Gravidarum and Treatment
While concentrating on signs and symptoms of hyperemesis gravidarum, it is important to identify the following ones: severe nausea, uncontrolled vomiting, sensitiveness to smells, changes in appetite, the weight loss, headache, fatigue, fever, dehydration, and possible abdominal pain (Wegrzyniak, Repke, & Ural, 2012). These symptoms are usually observed during weeks 5-9 of pregnancy. The signs are associated with the first trimester, but some women suffer from these symptoms till the third trimester of pregnancy (Almond, Edlund, Joffe, & Palme, 2016). In addition, the symptoms can be present during the day.
The treatment modalities proposed to overcome these symptoms are usually associated with the outpatient care, the non-pharmacological treatment, hospitalization, and the controlled use of medications. It is important to modify diets and consume the low-fat food. The regime should be focused on relaxing activities. In cases when medications are prescribed, it is possible to use pyridoxine and other antiemetics (Wegrzyniak et al., 2012). In severe cases, the parenteral nutrition and intravenous fluids are used during the hospitalization.
Nurses’ Activities to Support Women with Hyperemesis Gravidarum
Nurses should conduct the regular assessment of the female patient’s state. It is necessary to pay attention to signs of dehydration, assess the weight, control the fluid balance, and measure the patient’s temperature, blood pressure, and pulse rate. Nurses need to monitor changes in signs and the patient’s nutrition (Fletcher, Waterman, Nelson, Carter, & Dwyer, 2015). In cases when vomiting is severe and uncontrolled, a patient cannot take any food, and signs of dehydration are observed, it is necessary to contact a physician and test the urine for the presence of ketones (Duman et al., 2015). Nurses can monitor the patient’s state when the woman is at home or hospitalized. The emotional support provided by the nurse is also important because pregnant women with hyperemesis gravidarum can suffer from depression and fears regarding the condition’s effects on a fetus.
The Patient Education
The nurse’s responsibility is to educate a female regarding treatment modalities and opportunities to relieve the state. Women should be informed that proposed dietary plans, the consumption of carbohydrate, and provided medications are not harmful to a fetus, and they can work to relieve nausea (Bolin et al., 2013). Pregnant women should also be informed regarding benefits of consuming food in small portions frequently. It is important to inform females about the necessity of the regular and prolonged rest. In addition, it is also necessary to educate these women regarding daily assessments of their temperature, blood pressure, and weight (Wegrzyniak et al., 2012). They should also examine the skin turgor as a sign of dehydration. Moreover, women should note any changes in their state and inform a nurse or a physician regarding them to receive the additional assessment. Nurses can also educate females on how to conduct relaxation practices and cope with stress.
Effects of Hyperemesis Gravidarum on the Mother and Fetus
Hyperemesis gravidarum has a direct effect on the woman’s physical and psychological state. Females with hyperemesis gravidarum suffer from dehydration, the muscle weakness, fatigue, and nutrient deficiencies (Wegrzyniak et al., 2012). These states should be treated in order to avoid the further adverse effects. In addition, women can feel depressed, and they often report the high level of exhaustion (Nayeri, 2012). More psychological problems are associated with the relationships in the family because a woman needs the additional support and actual assistance in her daily life (Duman et al., 2015). When hyperemesis gravidarum is treated, and a woman follows the recommendations of nurses and physicians, risks for a fetus are minimal, or they are not indicated. If a woman suffers from the intense weight loss, and she does not receive the necessary nutrition with the help of injections, there is a risk that a baby’s weight will be rather low (Nayeri, 2012). Researchers and practitioners also determine other possible negative effects of hyperemesis on babies. They include the pre-term delivery, the development of chronic diseases, abnormalities, and defects of a neural tube among other ones that are rarely observed (Fletcher et al., 2015). The most effective approach to predict the development of complications for the mother and baby is the focus on the provided treatment and recommendations given by health care specialists.
Conclusion
Hyperemesis gravidarum is a severe complication of pregnancy that can have adverse effects on the woman’s physical and psychological state, as well as on the development of a fetus. However, complications are usually observed when the condition is not treated, and the woman’s nutritional status is low. Therefore, in order to avoid the negative impact on a baby and address the problems associated with hyperemesis, it is necessary to follow the dietary plan, contact nurses and physicians, and monitor changes in such symptoms as nausea, dehydration, and the weight loss. The adequate treatment and nutrition provided in time are effective measures to cope with sickness and vomiting, as well as other symptoms.
References
Almond, D., Edlund, L., Joffe, M., & Palme, M. (2016). An adaptive significance of morning sickness? Trivers-Willard and Hyperemesis Gravidarum. Economics & Human Biology, 21(1), 167-171.
Bolin, M., Akerud, H., Cnattingius, S., Stephansson, O., & Wikstrom, A. K. (2013). Hyperemesis gravidarum and risks of placental dysfunction disorders: A population‐based cohort study. An International Journal of Obstetrics & Gynaecology, 120(5), 541-547.
Duman, N. B., Ozcan, O., & Bostanci, M. O. (2015). Hyperemesis gravidarum affects maternal sanity, thyroid hormones and fetal health: A prospective case control study. Archives of Gynecology and Obstetrics, 292(2), 307-312.
Fletcher, S. J., Waterman, H., Nelson, L., Carter, L. A., & Dwyer, L. (2015). Holistic assessment of women with hyperemesis gravidarum: A randomised controlled trial. International Journal of Nursing Studies, 52(11), 1669-1677.
Nayeri, U. A. (2012). Hyperemesis in pregnancy: Taking a tiered approach. Contemporary OB/GYN, 12(7), 22-31.
Wegrzyniak, L. J., Repke, J. T., & Ural, S. H. (2012). Treatment of hyperemesis gravidarum. Reviews in Obstetrics and Gynecology, 5(2), 78-89.