What is the initial action before nutrition therapy for hyperemesis gravidarum?

• A. Treat fluid and electrolyte imbalances with IV fluids
• B. Begin PN immediately
• C. Start EN trial immediately
• D. Administer high-dose vitamins only

Answer: (A)

Stabilizing the patient by correcting fluid and electrolyte imbalances with IV fluids is the first action before nutrition therapy. Hyperemesis gravidarum often causes dehydration, electrolyte disturbances, and metabolic stress, so restoring volume and electrolyte balance sets the stage for safe and effective nutrition support. Once hydration and electrolytes are corrected, nutrition options can be pursued—enteral feeding if the gut tolerates it, or parenteral nutrition if enteral intake isn’t feasible. Initiating parenteral nutrition immediately or starting an enteral trial without first addressing the dehydration and imbalances would be inappropriate, and giving vitamins alone does not resolve the underlying instability.