Nursing Diagnosis : 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.

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Imbalanced Nutrition Less Than Body Requirements related to Loss of Appetite

Nursing Care Plan

Imbalanced Nutrition Less Than Body Requirements related to loss of appetite

Goal:

• Showed good nutritional status.

Expected outcomes are:

• Tolerance to dietary needs.
• Retain lean body mass and body weight within normal limits.
• Laboratory values ​​within normal limits.
• Reported adequacy of energy levels.

Imbalanced Nutrition Less Than Body Requirements related to loss of appetite - Intervention:
Independent:

• Create a meal plan with the patient, to put in a feeding schedule.
• Support family members to bring the patient's favorite food from home.
• Large portions of food offered during the day when a high appetite.
• Make sure the diet meets the needs of the body as indicated.
• Make sure the patient's diet is liked or disliked.
• Monitor input and expenditure and body weight periodically.
• Assess the patient's skin turgor.

Rational:

• Keeping the diet of patients so that patients eat regularly.
• Patients feel comfortable with food brought from home and can improve the appetite of the patient.
• By administering a large portion can maintain adequacy of nutrition intake.
• High carbohydrate, protein, and calories needed or required during treatment.
• To support the increasing appetite of the patient.
• Knowing the balance of intake and expenditure of food intake.
• As the data supporting a change of less nutritional needs.

Observation

• Monitor laboratory values​​, such as hemoglobin, albumin, and blood glucose levels.
• Teaches a method for meal planning.

Rational:

• In order to determine the level of Hb content deficiencies, albumin, and glucose in the blood.
• Clients used to eat in a planned and orderly.

Health Education

• Teach patients and families about nutritious food and not expensive.

Rational:

• Maintain the adequacy of intake of nutrients needed.

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Imbalanced Nutrition Less Than Body Requirements - Gastritis

Gastritis commonly refers to inflammation of the lining of the stomach, but the term is often used to cover a variety of symptoms resulting from stomach lining inflammation and symptoms of burning or discomfort. True gastritis comes in several forms and is diagnosed using a combination of tests. In the 1990s, scientists discovered that the main cause of true gastritis is infection from a bacterium called Helicobacter pylori (H. pylori).



Nursing Diagnosis for Gastritis: Imbalanced Nutrition Less Than Body Requirements

Expected outcomes are:

• stable weight,
• laboratory values​​: normal albumin,
• no nausea and vomiting,
• body weight within normal limits,
• normal bowel sounds.

Nursing Interventions Imbalanced Nutrition Less Than Body Requirements - Gastritis:

• assess food intake,
• weight measured regularly,
• provide oral care on a regular basis,
• encourage clients to eat little but often,
• provide food in warm,
• auscultation of bowel sounds,
• examine food preferences,
• supervised laboratory tests such as hemoglobin, hematocrit, albumin.

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