Hyperemesis Gravidarum

Course #33174 - $30 -

Overview

Between 50% and 80% of pregnant women experience nausea and vomiting beginning about the 4th week and ending about the 12th week of gestation. In fact, nausea and vomiting are considered a presumptive sign of pregnancy and for about 10% to 20% of pregnant women, these symptoms may persist throughout the whole pregnancy. While nausea and vomiting are common occurrences, hyperemesis gravidarum is rare, occurring in about 0.2% to 3.6% of all pregnancies. In this course, theories of etiology will be presented, as well as the pathophysiology of the disorder. Medical, pharmacologic, and nonpharmacologic interventions will be reviewed. The nurse's role in diagnosis, treatment, and patient education will be discussed.

Education Category: Women's Health - Maternal / Child
Release Date: 09/01/2023
Expiration Date: 08/31/2026

Table of Contents

Audience

This course is designed for all nurses, especially those working in obstetrics and maternal/child nursing.

Accreditations & Approvals

In support of improving patient care, NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this continuing education activity for 5 ANCC contact hour(s). NetCE designates this continuing education activity for 1 pharmacotherapeutic/pharmacology contact hour(s). NetCE designates this continuing education activity for 6 hours for Alabama nurses. NetCE is authorized by IACET to offer 0.5 CEU(s) for this program. AACN Synergy CERP Category A.

Individual State Nursing Approvals

In addition to states that accept ANCC, NetCE is approved as a provider of continuing education in nursing by: Alabama, Provider #ABNP0353, (valid through July 29, 2025); Arkansas, Provider #50-2405; California, BRN Provider #CEP9784; California, LVN Provider #V10662; California, PT Provider #V10842; District of Columbia, Provider #50-2405; Florida, Provider #50-2405; Georgia, Provider #50-2405; Kentucky, Provider #7-0054 through 12/31/2025; South Carolina, Provider #50-2405; West Virginia RN and APRN, Provider #50-2405.

Course Objective

Practitioners commonly treat nausea and vomiting in early pregnancy, regardless of whether the patient fits all the criteria of a diagnosis of hyperemesis gravidarum. The purpose of this course is to increase the awareness of hyperemesis gravidarum and present guidelines for nursing management of the condition.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Define hyperemesis gravidarum, and distinguish it from the normal nausea and vomiting of pregnancy.
  2. List the potential effects of hyperemesis gravidarum on the fetus and mother.
  3. Compare the various theories of etiology of hyperemesis gravidarum.
  4. Identify the populations at risk for hyperemesis gravidarum.
  5. Describe dietary interventions for treatment of hyperemesis gravidarum.
  6. Describe pharmacologic agents used in the management of hyperemesis gravidarum.
  7. Describe the role of intravenous therapy in treating hyperemesis gravidarum.
  8. Outline nonpharmacologic interventions to treat hyperemesis gravidarum.
  9. Explain the nursing assessment and related diagnosis and interventions for the patient with hyperemesis gravidarum.

Faculty

Sandra Mesics, CNM, MSN, RN, is a native of Bethlehem, Pennsylvania. She attended Penn State University where she graduated with a BS in Psychology. In 1983, she moved to Miami, Florida, where she earned a BS degree in Nursing at Barry University, graduating magna cum laude. Ms. Mesics worked as an RN in Labor & Delivery, postpartum, and newborn nursery at Mount Sinai Medical Center, Miami Beach, FL, and started work on her Master's degree in 1994. She became a certified nurse-midwife in 1997, and was the first nurse-midwife granted privileges at Mount Sinai Hospital of Greater Miami. In 2001, Ms. Mesics returned to Bethlehem, PA, to accept a faculty position teaching maternity nursing at St. Luke's School of Nursing. She also maintains privileges at St. Luke's Hospital, providing nurse-midwifery care in the women's health clinic. In 2004, Ms. Mesics became director of the School of Nursing. She is a member of Sigma Theta Tau Nursing Honor Society, the American College of Nurse-Midwives, and the National League for Nursing. She served on the advisory committee for fetal fibronectin.

Faculty Disclosure

Contributing faculty, Sandra Mesics, CNM, MSN, RN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planner

Margo A. Halm, RN, PhD, NEA-BC

Division Planner Disclosure

The division planner has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Director of Development and Academic Affairs

Sarah Campbell

Director Disclosure Statement

The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Disclosure Statement

It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

Implicit Bias in Health Care

The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.

Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.