Hyperemesis Gravidarum: Clinical Assessment & Management

1. A pregnant client with hyperemesis gravidarum develops jaundice and right upper quadrant pain. What complication should be suspected?

Gestational diabetes

Hepatic dysfunction or cholestasis

Preeclampsia

Appendicitis

2. Which nursing diagnosis is most appropriate for a client hospitalized with severe hyperemesis gravidarum?

Ineffective coping

Deficient fluid volume related to excessive vomiting

Imbalanced nutrition: less than body requirements

Both b and c

3. A client with hyperemesis gravidarum has metabolic alkalosis with elevated bicarbonate and low chloride. What is the likely cause?

Respiratory acidosis

Loss of gastric acid through vomiting

Diabetic ketoacidosis

Lactic acidosis

4. Which hormone elevation is associated with increased severity of hyperemesis gravidarum?

Progesterone

Human chorionic gonadotropin (hCG)

Estrogen

Prolactin

5. True or False: Psychological factors are the primary cause of hyperemesis gravidarum.

True

False

6. A client with hyperemesis gravidarum is receiving total parenteral nutrition (TPN). What is the primary nursing consideration?

Monitor for catheter-related bloodstream infection

Ensure daily weight gain of 1–2 kg

Restrict fluid intake

Encourage oral intake immediately

7. Which complication of hyperemesis gravidarum results from forceful vomiting and requires endoscopic evaluation?

Gastric perforation

Mallory-Weiss tear

Peptic ulcer disease

Pyloric stenosis

8. A client with hyperemesis gravidarum reports severe nausea that worsens with odors and motion. What nursing intervention is most appropriate?

Encourage small, frequent meals

Minimize environmental triggers and provide cool, fresh air

Increase caloric intake at each meal

Restrict all oral intake

9. Which assessment finding most reliably indicates severe dehydration in a client with hyperemesis gravidarum?

Mild tachycardia (100–110 bpm)

Orthostatic hypotension and elevated hematocrit

Dry mucous membranes alone

Absence of thirst

10. True or False: Ginger supplementation has no scientific evidence supporting its use in hyperemesis gravidarum.

True

False

11. Hyperemesis gravidarum is defined as intractable nausea and vomiting during pregnancy that occurs in what percentage of pregnancies?

0.5–1%

2–3%

5–10%

15–20%

12. Which non-pharmacological intervention is supported by evidence for managing hyperemesis gravidarum?

Acupressure at the P6 point

High-fat, high-protein meals

Increased fluid intake with meals

Prolonged fasting periods

13. A client requires hospitalization for hyperemesis gravidarum. Which laboratory finding would indicate the need for intravenous fluid replacement?

Serum sodium 135 mEq/L

BUN-to-creatinine ratio >20:1

Serum chloride 98 mEq/L

Hemoglobin 11.5 g/dL

14. True or False: Hyperemesis gravidarum has no significant impact on fetal growth and development if managed appropriately.

True

False

15. Which vitamin deficiency is a serious concern in prolonged hyperemesis gravidarum due to increased risk of fetal neurological damage?

Vitamin A deficiency

Thiamine (vitamin B1) deficiency

Vitamin D deficiency

Vitamin C deficiency

16. A client with hyperemesis gravidarum is found to have a serum potassium of 2.8 mEq/L. What clinical sign would you expect to assess?

Hyperreflexia and tremor

Muscle weakness and cardiac arrhythmias

Hypertension and headache

Increased salivation

17. True or False: Hyperemesis gravidarum typically resolves by the end of the first trimester in most cases.

True

False

18. Which medication is considered first-line pharmacological treatment for hyperemesis gravidarum?

Metoclopramide

Ondansetron

Doxylamine and pyridoxine

Promethazine

19. A pregnant client at 10 weeks gestation presents with persistent vomiting, weight loss of 5 kg, and dark urine. What is the priority nursing concern?

Nutritional deficiency

Fluid and electrolyte imbalance

Psychological distress

Fetal anomaly risk

20. Which electrolyte imbalance is most commonly associated with severe hyperemesis gravidarum?

Hyperkalemia

Hypokalemia

Hypercalcemia

Hypernatremia

Hyperemesis Quiz: When Is Vomiting Dangerous?

1. A pregnant client with hyperemesis gravidarum develops jaundice and right upper quadrant pain. What complication should be suspected?

2.

What first name or nickname would you like us to use?

2. Which nursing diagnosis is most appropriate for a client hospitalized with severe hyperemesis gravidarum?

3. A client with hyperemesis gravidarum has metabolic alkalosis with elevated bicarbonate and low chloride. What is the likely cause?

4. Which hormone elevation is associated with increased severity of hyperemesis gravidarum?

5. True or False: Psychological factors are the primary cause of hyperemesis gravidarum.

6. A client with hyperemesis gravidarum is receiving total parenteral nutrition (TPN). What is the primary nursing consideration?

7. Which complication of hyperemesis gravidarum results from forceful vomiting and requires endoscopic evaluation?

8. A client with hyperemesis gravidarum reports severe nausea that worsens with odors and motion. What nursing intervention is most appropriate?

9. Which assessment finding most reliably indicates severe dehydration in a client with hyperemesis gravidarum?

10. True or False: Ginger supplementation has no scientific evidence supporting its use in hyperemesis gravidarum.

11. Hyperemesis gravidarum is defined as intractable nausea and vomiting during pregnancy that occurs in what percentage of pregnancies?

12. Which non-pharmacological intervention is supported by evidence for managing hyperemesis gravidarum?

13. A client requires hospitalization for hyperemesis gravidarum. Which laboratory finding would indicate the need for intravenous fluid replacement?

14. True or False: Hyperemesis gravidarum has no significant impact on fetal growth and development if managed appropriately.

15. Which vitamin deficiency is a serious concern in prolonged hyperemesis gravidarum due to increased risk of fetal neurological damage?

16. A client with hyperemesis gravidarum is found to have a serum potassium of 2.8 mEq/L. What clinical sign would you expect to assess?

17. True or False: Hyperemesis gravidarum typically resolves by the end of the first trimester in most cases.

18. Which medication is considered first-line pharmacological treatment for hyperemesis gravidarum?

19. A pregnant client at 10 weeks gestation presents with persistent vomiting, weight loss of 5 kg, and dark urine. What is the priority nursing concern?

20. Which electrolyte imbalance is most commonly associated with severe hyperemesis gravidarum?