A pregnant patient has persistent vomiting with weight loss and ketonuria. What is the likely diagnosis and key nursing interventions?

• A. Hyperemesis gravidarum; initiate IV fluids with electrolyte correction, administer antiemetics, and monitor weight.
• B. Nausea of pregnancy; encourage small frequent meals and fluids only.
• C. Molar pregnancy; prepare for suction curettage.
• D. Gastroenteritis; isolate the patient and administer oral rehydration.

Answer: (A)

Recognizing a more serious pregnancy-related condition is key here: persistent vomiting with weight loss and ketonuria points to hyperemesis gravidarum, not routine morning sickness. Ketonuria means the body is breaking down fat for fuel because intake is insufficient, signaling dehydration and electrolyte imbalance from ongoing vomiting. The nursing priorities are to restore hydration and correct electrolytes, control nausea to prevent further losses, and monitor nutritional status.

Initiating IV fluids with electrolyte correction directly addresses dehydration and electrolyte disturbances. Administering antiemetics helps reduce vomiting and prevent further depletion, making it easier to maintain intake. Regularly weighing the patient provides a clear measure of nutritional status and response to treatment, guiding ongoing care. Additional supportive steps include monitoring intake and output, vital signs, and fetal status, with escalation if weight loss or ketonuria persists.