👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: severe morning sickness · extreme pregnancy vomiting · constant vomiting in pregnancy
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Use this quick-reference guide to spot, treat, and prevent Hyperemesis Gravidarum on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🩺 Signs
Severe persistent N/V
Wt loss > 5%, dehydration
🧪 Labs
Ketonuria, ↑ urine specific gravity
↓ K+, ↓ Na, metabolic alkalosis
✅ Do
IV fluids, correct electrolytes
NPO then small bland meals
Antiemetics, vit B6, ginger
🚩 Report
No urine, ↑ HR, ↓ BP, ketones
📚 Hyperemesis Gravidarum — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Hyperemesis gravidarum is severe, persistent nausea and vomiting of pregnancy that leads to dehydration, electrolyte imbalance, weight loss (more than 5% of pre-pregnancy weight), and ketosis. Unlike normal morning sickness, it does not resolve and prevents adequate intake of food and fluids. It is linked to high levels of hCG and is more common in molar and multiple pregnancies. It matters because untreated it causes maternal malnutrition and dehydration.
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Key points
Understand these first
Vomiting is excessive and unrelenting, causing weight loss of 5% or more of pre-pregnancy weight.
Sodium and chloride decrease; arterial pH may show metabolic alkalosis
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Patient teaching
What patients must know
Eat small, frequent, bland, dry meals such as crackers and avoid greasy, spicy, or strong-smelling foods.
Separate fluids from solid meals and sip fluids slowly throughout the day.
Report inability to keep food or fluids down, decreased urination, or dizziness so dehydration can be treated.
❓ Hyperemesis Gravidarum: NCLEX FAQs
What are the priority nursing interventions for Hyperemesis Gravidarum?
Maintain NPO status initially, then advance the diet slowly as tolerated once vomiting is controlled. Administer IV fluids with electrolyte replacement to correct dehydration and imbalances. Give prescribed antiemetics (such as pyridoxine/doxylamine, promethazine, or ondansetron) and thiamine as ordered. Monitor intake and output, daily weight, and urine for ketones to track hydration and nutrition status.
What are the warning signs of Hyperemesis Gravidarum a nurse must report?
Report signs of severe dehydration: oliguria, marked tachycardia, hypotension, and large urine ketones. Report persistent vomiting with weight loss and inability to keep fluids down, requiring IV therapy. Watch for severe hypokalemia, which can cause dysrhythmias. Report confusion or neurological changes, which may indicate thiamine deficiency (Wernicke encephalopathy).
What do I need to know about Hyperemesis Gravidarum for the NCLEX?
Vomiting is excessive and unrelenting, causing weight loss of 5% or more of pre-pregnancy weight. Dehydration produces dry mucous membranes, poor skin turgor, tachycardia, and concentrated, ketone-positive urine. Prolonged vomiting causes electrolyte imbalances, classically hypokalemia and metabolic alkalosis from loss of gastric acid. Very high hCG levels are associated with the condition, including in molar and multiple pregnancies.
What patient teaching is important for Hyperemesis Gravidarum?
Eat small, frequent, bland, dry meals such as crackers and avoid greasy, spicy, or strong-smelling foods. Separate fluids from solid meals and sip fluids slowly throughout the day. Report inability to keep food or fluids down, decreased urination, or dizziness so dehydration can be treated.
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Quick Tip
Vomiting is excessive and unrelenting, causing weight loss of 5% or more of pre-pregnancy weight.