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Occasional nausea that is relieved by eating is a characteristic of physiological "morning sickness" rather than hyperemesis. In hyperemesis, oral intake usually precipitates further vomiting, making relief through eating impossible. This finding suggests a mild form of pregnancy-associated nausea that does not meet the criteria for pathological emesis.

Vomiting once daily in the evening is inconsistent with the persistent and intractable nature of hyperemesis. Hyperemesis involves continuous or multiple daily episodes that interfere with activities of daily living. A single daily episode lacks the frequency required to cause the severe dehydration and ketonuria seen in this clinical syndrome.

Mild dehydration with normal electrolyte levels does not reflect the severity of hyperemesis gravidarum. True hyperemesis is associated with electrolyte disturbances such as hypochloremic metabolic alkalosis and hypokalemia. Normal levels suggest that the body's homeostatic mechanisms are still intact, whereas hyperemesis involves a failure of these compensatory systems.

A urine specific gravity of 1.010 is within the normal range (1.005 to 1.030) and indicates adequate hydration. In hyperemesis gravidarum, the nurse would expect to see a high specific gravity (≥ 1.025) due to severe fluid volume deficit and compensatory renal water reabsorption. A reading of 1.010 suggests that the kidneys are not currently under the osmotic stress associated with severe dehydration.

The absence of ketones in the urine would suggest that the client’s energy demands are still being met by glucose and glycogen stores. Since hyperemesis is defined by its ability to cause starvation-level metabolic changes, a negative ketone test would point away from this diagnosis. Normal nausea of pregnancy rarely results in the persistent ketosis required to be labeled as hyperemesis.

A stable maternal weight is a strong indicator that the client is not suffering from hyperemesis gravidarum. The diagnostic criteria specifically require a weight loss exceeding 5% of the pre-pregnancy baseline. Stable weight implies that the client is maintaining a positive or neutral caloric balance, whereas hyperemesis is fundamentally a state of progressive nutritional depletion.

A complete blood count is used to assess for hemoconcentration (elevated hematocrit) and infection, but it cannot identify the source of hormonal elevation. While it helps the nurse understand the degree of dehydration caused by the vomiting, it provides no anatomical information regarding the pregnancy. It is a supportive laboratory test rather than a confirmatory tool for trophoblastic disease.

An electrocardiogram is indicated if the client exhibits severe electrolyte imbalances, such as hypokalemia, which can lead to cardiac dysrhythmias. While it monitors the cardiovascular effects of persistent emesis, it does not address the underlying etiology of the vomiting. It is a safety intervention for managing complications but is not a diagnostic test for molar pregnancy.

Liver function tests are often ordered in severe hyperemesis to monitor for transaminitis, which occurs in approximately 50% of hospitalized cases. Elevated AST and ALT levels can indicate hepatic stress from starvation or dehydration, yet these findings are non-specific. They do not distinguish between primary hyperemesis and the high-hCG state of a hydatidiform mole.