Overview of Nausea

Writing a nursing care plan for nausea is a common undertaking for practicing nurses. In nursing college, you are likely to come across the care plan as an assessment meant to ascertain your skills on how to write a college assignment.

Just like in the case of EBP in nursingnursing care plan for bleeding, or nursing care for pneumonia, you will be required to demonstrate the understanding of the Evidence-Based Practice (EBP) approach.

In the case of care plan for nausea, you need to start with an appropriate nausea definition. Accordingly, nausea can be defined as:

“An uneasy and uncomfortable sensation in the upper stomach characterized by involuntary urge to vomit.”

Note that nausea usually occurs before vomiting. Nonetheless, one can suffer nausea without necessarily vomiting.

 

Related Factors

To develop a good nursing care plan for nausea, you need to identify the different factors that are related to nausea. These factors principally entail the different nausea causes.

Per se, these factors could be grouped into 3 categories that include:

 

Situational

Factors under this category involve:

1. Bulimia

2. Reaction to odors and smells

3. Overeating

4. Fear

4. Pain

5. Noxious stimuli

 

Biophysical

Related factors include:

1. Infections

2. Cough

3. Cardiac pain

4. Gastrointestinal diseases

5. Bowel obstruction

6. Vestibular problems

7. Motion sickness

8. Cancer

9. Increased ICP

10. Tumors

11. Peritonitis

12. Toxins

13. Pregnancy

14. Uremia

 

Treatment related

Factors under this category encompass:

1. Postoperative elements

2. Tube feeding

3. Gastric distention

4. Stomach upset resulting from drugs, alcohol, iron, or blood

5. Medications such as aspirin, analgesics, opioids, HIV treatment, chemotherapy, or radiotherapy

 

Defining Characteristics

Note that developing a nursing care plan for nausea demands a good understanding of the respective defining characteristics.

As such, some of the signs and symptoms that characterize nursing diagnosis in the case of nausea include:

1. Reports of nausea

2. Gagging sensation

3. Sour taste in the mouth

4. Allergy to food

5. Excessive salivation

6. Increased swallowing

 

Goals and Outcomes

Goals and outcomes are an important element in a nursing care plan for nausea. That said, in a nausea nursing diagnosis, common goals and anticipated outcomes include:

1. Reduction in nausea severity or

2. Complete elimination of nausea.

 

Nursing Assessment for Nausea

Developing a nursing care plan for nausea requires you to come up with appropriate assessments. In this, nursing diagnosis assessments for nausea may entail:

 

AssessmentScientific Rationale
Determining nausea causes.Assessment on the patient with nausea causes is done to guide the intervention choices selected.

When the stimulus is identified, it can be eliminated, and therefore making treatment unnecessary.

Assessing characteristics of the nausea. Determine:

1. History

2. Frequency

3. Severity

4. Duration

5. Precipitating factors

6. Medications

7. Alleviation measures

A through nausea assessment and evaluation could help identify interventions to reduce the problem.
Note down the daily weights, hydration status, intake and output, BP, and skin turgor of the patient.Nausea is commonly associated with vomiting, which can alter the hydration status of the patient as a result of loss of fluids.

 

Nursing Interventions for Nausea

After the assessment, you should go ahead and devise respective nursing interventions to be adopted in your nursing care plan for nausea.

Common nursing interventions are as illustrated below.

 

Nursing InterventionScientific Rationale
Provide the patient with a vomiting basin that is easily reachable.Vomiting is closely related to nausea. The basin should be kept within reach but out of sight just in case the nausea the patient is experiencing has a psychogenic component.
Help the patient through the diagnostic testing preparation.Numerous tests could be used to identify the causing factor, including computed tomography scan for the abdomen, study of the gastrointestinal tract, and ultrasonography.
Teach the patient about oral hygieneThis relates to excessive salivation and anorexia. In the case of the two, oral hygiene is key in alleviating the condition and it as well increases comfort.
Remove strong odors from close environment, including dressings, perfumes, and vomit.Strong and noxious odors are contributing factors to nausea.
Instruct the patient to adopt non-pharmacological techniques for controlling nausea like guided imagery, relaxation, deep breathing, distraction, and music therapy.These methods are effective in alleviation of the condition, however, they should be applied before the occurrence of the condition.
Maintain fluid balance for patients at risk.Effective hydration before clinical procedures like chemotherapy or surgery can decrease nausea occurrence risk.
Add ice chips, cold water, bouillon, room temperature broth, and ginger products to the patient’s diet if they can be stomached and are appropriate.These would help in maintaining hydration. Extremely hot or cold fluids could be intolerable for the patient.

Ginger aids in relieving nausea, where it can be taken in the form of ginger tea, ginger ale, crystalized ginger, or chewed ginger.

Apply acupressure or use acustimulation bands as required.The Neiguan P6 acupuncture point stimulation on the wrist ventral surface controls some nausea points.

The intervention is effective for patients experiencing motion-induced nausea.

Put the patient in an upright position when eating and 1-2 hours after eating.Maintaining this position would help reduce the risk for nausea.
Provide the patient with small amounts of food appealing to them in frequent series.This would aid in ensuring good nutritional status.

Some patients experience exacerbated nausea due to an empty stomach.

Provide bland and basic foods such as rice, broth, Jell-O, or bananas.Patients are likely to endure these food types compared to others.

The patient should try and eat more when nausea recedes.

Provide dry foods such as toast or crackers.Toast and crackers are effective in reducing nausea related to pregnancy.
Instruct the patient to avoid foods and other things with smells that can induce nausea.Noxious and strong odors can cause nausea.
Require the patient to take antiemetics as guided.Majority of the antiemetics increase the chemoreceptor trigger zone threshold to stimulation.

Antiemetic drugs include anticholinergics, antihistamines, dopamine antagonists, benzodiazepines, and serotonin receptor antagonists.

Cannabinoids and glucocorticoids effectively treat nausea and vomiting induced by chemotherapy.

Antiemetics when taken by preoperative patient before surgery reduce nausea and vomiting post operation.

Evaluate the prenatal vitamins being taken in cases where the patient is pregnant.Excess iron intake could cause nausea, where changing the type of vitamins intake could reduce the problem.
Teach the patient how to take medications based on the prescription.Taking medications in line with the prescribed schedule lowers nausea episodes.
Teach the patient and caregivers the appropriate options for fluids and diet for nausea.Patients and caregivers could facilitate realization of effective hydration levels and nutritional status through proper consideration of dietary points during nausea incidences.
Ensure effective ventilation of rooms. Help the patient experience outside fresh air.Effective ventilation, outside environment, and use of a fan facilitates effective breathing.
Teach the patient how to change positions slowly and steadily.Abrupt or crude movements are likely to worsen nausea.
Teach the patient or caregiver how to use acupressure or accustimulation bands.Patients and caregivers could wish to go ahead with the intervention if it worked effectively on them.
Examine response to antiemetics or nausea alleviating interventions.This would aid in establishing the effectiveness of respective interventions.
Instruct the patient or caregiver to look for medical attention when vomiting starts or perseveres for more than 24 hours.Unending vomiting can cause nutritional deficiencies, electrolyte imbalance, and dehydration.

 

MSN, RN.
Essie Fitz is a registered nurse with over 15 years experience in pain management, hospice care, and ICU.
She enjoys mentoring new nurses and nursing students.
She loves nature, reading, writing, and good music.

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