Nausea and Vomiting
Nausea and vomiting (NV) are unpleasant features of many medical conditions and are adverse effectsof hundreds of medications. Commonly seen in the critically ill patient, these symptoms are not often the cause for admission to critical care, but complicate and may extend the length of hospital stay.1 Further, in these patients, nausea and vomiting can lead to seriouscomplications such as aspiration pneumonia, dehydration, malnutritionand disruption of the surgical site.2
A term often used together, nausea and vomiting are basic protective reflexes againstthe absorption of toxins, as well as responses to certain stimuli. Nausea is an unpleasant sensation associated with pallor, flushing andtachycardia, along with an awareness of the urge to vomit. Vomiting or emesis is characterized by abdominal muscles contraction and forceful expulsion of stomachcontents through the mouth.
The American Gastroenterological Association suggests a 3-step approach to the initial evaluation of nausea and vomiting:3
Causes of nausea and vomiting
A wide variety of disorders can induce nausea and vomiting.
Common causes include the following:
The timing of the nausea and vomiting can indicate the cause. If the symptom occurs shortly after a meal, it may indicate peptic ulcer. Nausea or vomiting that start 1–8 h after a meal may indicate food poisoning.
Those who experience nausea and vomiting for more than 1 week should be investigated for the possibility of pregnancy. Vomiting usually subsides within 6–24 h, and may be treated at home.
Management of nausea and vomiting
The management of patients with nausea and vomiting should address the following:
The occasional episode of nausea and vomiting requires no treatment except rest and frequent small amounts of fluid. Mild and uncomplicated nausea and vomiting may be treated empirically with oral antiemetics. Severe intractable episodes require fluid replacement, correction of electrolyte and acid-base abnormalities and parenteral administration of antiemetics.
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Written by: Healthplus24 team
Date last updated: September 29, 2012
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