Patient presents with nausea and vomiting in pregnancy, clinically consistent with hyperemesis gravidarum (HG) versus morning sickness.  Onset of symptoms was [timeframe] at [gestational age].  Frequency of vomiting is [frequency] with associated symptoms including [list symptoms, e.g.,  ptyalism, fatigue, weight loss, dehydration, electrolyte imbalance, ketonuria].  Patient reports [food aversions or triggers].  Severity of nausea and vomiting is impacting [daily activities, hydration, nutrition]. Prenatal vitamins [are/are not tolerated].  Weight documented at [weight] with a [gain/loss] of [amount] since last visit.  Vital signs: blood pressure [blood pressure reading], heart rate [heart rate reading], temperature [temperature reading].  Physical examination revealed [findings, e.g., dry mucous membranes,  skin turgor].  Differential diagnosis includes gastroenteritis, gastroparesis, cholecystitis, pancreatitis, pyelonephritis, and preeclampsia.  Assessment: Nausea and vomiting during pregnancy (NVP), likely hyperemesis gravidarum given [clinical findings supporting HG].  Plan:  Patient counseling provided on dietary modifications, including small, frequent meals, bland foods, and ginger.  Prescribed [medication and dosage, e.g., Vitamin B6, doxylamine, ondansetron].  Laboratory tests ordered: [tests ordered, e.g.,  CBC, CMP, urinalysis, urine ketones].  Patient advised to monitor urine output and signs of dehydration.  Follow-up scheduled in [timeframe] to reassess symptoms and treatment efficacy.  Patient education provided on warning signs and when to seek immediate medical attention. ICD-10 code: [O21.1, O21.2, or other appropriate code depending on severity].