Imbalanced Nutrition related to Hyperemesis Gravidarum

Nursing Care Plan for Hyperemesis Gravidarum - Nursing Diagnosis : Imbalanced Nutrition: less than body requirements

Hyperemesis Gravidarum

Nausea and vomiting (emesis gravidarum) is a natural phenomenon and is often caught in the first trimester of pregnancy. Nausea usually occurs in the morning, but can arise at any time and at night. These symptoms occur approximately 6 weeks after the first day of the last menstrual period and lasts for approximately 10 weeks. Nausea and vomiting occur in 60-80% primi gravida and 40-60% multi gravida. One in every thousand pregnancies, these symptoms become more severe.

Nausea is largely attributable because of increased levels of estrogen and HCG (Human Chorionic Gonadrotropin) in serum. Physiological effect of the hormone increase is not clear, probably because the central nervous system or the gastric emptying of the stomach is reduced. In general, women can adapt to this situation, though symptoms of severe nausea and vomiting that can last up to 4 months. Daily work was interrupted, and the general condition became worse. This condition is called hyperemesis gravidarum. Complaints of symptoms and physiological changes determine the severity of the disease. (Prawirohardjo, 2002)

Hyperemesis gravidarum is defined as excessive vomiting or uncontrolled during pregnancy, which causes dehydration, electrolyte imbalance, or nutritional deficiencies, and weight loss. The incidence of this condition is approximately 3.5 per 1000 births. Although most cases of missing and disappeared over time, one out of every 1,000 pregnant women will undergo hospitalization. Hyperemesis gravidarum usually disappear on their own (self-limiting), but healing is slow and frequent relapses are common. The condition often occurs among primigravida women and tends to recur in subsequent pregnancies. (Lowdermilk, 2004).


Nursing Diagnosis for Hyperemesis Gravidarum : Imbalanced Nutrition: less than body requirements related to excessive frequency of nausea and vomiting.

Nursing Intervention for Hyperemesis Gravidarum

1. Limit oral intake until the vomiting stops.
R /: Maintain electrolyte fluid balance and prevent further vomiting.

2. Give anti-emetic drugs are prescribed at low doses.
R /: Preventing vomiting and maintain fluid and electrolyte balance.

3. Maintain fluid therapy is programmed.
R /: Correct the hypovolemia and electrolyte balance.

4. Record intake and output.
R /: Determining hydration fluids through vomiting and spending.

5. Anjurjan eat small meals but often.
R /: Can adequate intake of nutrients your body needs.

6. Instruct to avoid fatty foods.
R /: to stimulate nausea and vomiting.

7. Instruct the patient to eat a snack such as biscuit, bread and hot tea before getting out of bed during the day and before bed.
R /: Food distraction can reduce or avoid excessive excitatory nausea vomiting.

8. Record intake, if oral intake can not be given within a certain period.
R /: To maintain a balance of nutrients.

9. Inspection of an irritation or lesions in the mouth.
R /: To determine the integrity of the oral mucosa.

10. Assess oral hygiene and personal hygiene as well as the use of oral cleaning fluids as often as possible.
R /: To maintain the integrity of the oral mucosa.

11. Monitor hemoglobin and hematocrit.
R /: Identify the potential anemia and decreased oxygen-carrying capacity of the mother.

12. Test urine for acetone, albumin and glucose.
R /: Establish baseline data; performed routinely to detect potential high-risk situations such as the inadequate intake of carbohydrate, diabetic and hypertension due to pregnancy ketoasedosis.

13. Measure uterine enlargement.
R /: Malnutrition affects maternal fetal growth and aggravate komplemensel decrease in fetal brain, resulting in deterioration of fetal development and the possibilities further.