Nausea, Hyperemesis

Body

#Nausea/Vomiting in Pregnancy: PUQE score
-Sx hypovolemia?
-Electrolytes? Weight loss (>5% = HG)? Ketonuria?
-CMP, Mg, Phos, U/A, CBC, TFTs
-FWB:
-Ginger + pyridoxine 10-25mg q6h (or in combination with Doxylamine 10mg)  --> benadryl, meclizine (then see below)
-Counseled patient to return to triage if she is unable to take PO for >12 hours, experiences dizziness upon standing, or unrelenting vomiting

#Hyperemesis gravidarum: VSS, afebrile. Admit to Antepartum service.
- Pregnancy diet ADAT, IVF until tolerating PO
- AM BMP/***CMP***; replete electrolytes PRN
- maintenance IVF + thiamine 100mg QD (x 3d)
- Famotidine 20 mg IV Q12 hr***
- Promethazine IV 25 mg Q6 hr***
- Metoclopramide IV 10 mg Q6 hr***
- If symptoms persist x 24h, can consider adding ondansetron 4-8mg IV q8h prn

Yellow *** markers = placeholders you fill in or delete per case.