In the context of hyperemesis gravidarum, a weight loss of 3 pounds in two days typically indicates dehydration and necessitates what initial action?

• A. Initiate intravenous fluids
• B. Start oral rehydration therapy only
• C. Discontinue all medications
• D. Schedule bed rest

Answer: (A)

Dehydration from vomiting in hyperemesis gravidarum is a volume deficit that can affect both mom and baby, so the first step is to restore fluids directly through the veins. A weight loss of about 3 pounds in two days signals that intravascular volume is depleted, making rapid rehydration essential to improve circulation, urine output, and electrolyte balance. Starting isotonic IV fluids (like normal saline or lactated Ringer’s) provides reliable volume replacement and allows ongoing assessment and electrolyte correction as needed. Relying on oral rehydration alone is unlikely to replete volume quickly enough when vomiting persists, and the other options don’t address the immediate need to restore circulating volume and electrolyte status.