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Nausea and Vomiting
| Question | Answer |
|---|---|
| What are the four most common self-treatable causes of Nausea and vomiting? | motion sickness, Nausea and vomiting during pregnancy, viral gastroenteritis, upset stomach from overeating and indigestion |
| How is motion sickness caused? | overstimulation to the inner ear due to unusual motion, inaccurate interpretation of visual stimuli |
| how is NVP caused? | possibly increased hormones and slower movement of stomach contents |
| How is overeating caused? | gut distension and decreased GI emptying that stimulate mechanoreceptors |
| What are some exclusions for self treatment of N/V in adults? | if food poisoning doesnt resolve in 24 hours, severe abdominal in the bottom right quadrant, N/V with fever, blood in vomit, yellow skin, stiff neck, etc |
| Nonpharm for NV: stimulation of pressure point: what do you do | press on inner forearm with 3 fingers up from the wrist crease |
| Nonpharm for NV: accupressure wristband: what does it treat | prevents motion sickness and symptoms of NV |
| Nonpharm for NV: accupressure wristband: any cautions? | may cause a rash |
| Nonpharm for NV: preventing motion sickness. What to do? | avoid reading during travel, focus on line of vision during travel, avoid excess food before travel, sit at the wings of the plane, front of car, mid ship, avoid strong odors, be in control of vehicle (JACK THE AIRPLANE) |
| Nonpharm for NV: preventing NVP: | eat dry crackers 15 mins before getting out of bed, eat 4-5 small meals, dont let stomach get empty, drink small sips of carbonated drinks, avoid greasy, acidic, spicy food, increase protein intake, eat chilled food avoid smelling |
| Pharm therapy for NV: what meds to take for motion sickness | antihistamines like meclizine, cyclizine, dimenhydranate, diphenhydramine |
| Pharm therapy for motion sickness: when do you take these meds | 30 -60 miutes prior to activity that causes the NV |
| Pharm therapy for motion sickness: side effects | drowsiness, paradoxal stimulation, blurred vision, constipation, difficulty peeing |
| Pharm therapy for motion sickness: warnings | overdose, lactation, respiratory conditions, children and elderly due to side effects |
| Pharm therapy for overeating: what are some meds for this | busmuth subsalycilate and phosphorated carb soln. |
| Pharm therapy for overeating: cautions | dont take an hour or less before doing activity that causes NV, dont exceed 5 doses, dont silute solution with water |
| Pharm therapy for NVP: what are some meds for this | doxylamine, pyridoxine |
| Pharm therapy for NVP: side effects | pyridoxine: neuropathic disturbances. Doxylamine: drowsiness |
| pharm therapy for viral gastroenteritis: adults | usually goes away on its own and you dont need meds |
| pharm therapy for viral gastroenteritis: children | oral rehydration stuff |
| additional pharm therapy: what can be used | ginger and chamomile and peppermint |
| What are the four main causes of diarrhea | viral gastroenteritis, bacterial gastroenteritis, protazoal diarrhea, food induced |
| what are two types of acute diarrhea? | osmotic and secreatory |
| what are two types of chronic diarrhea? | inflammatory and motor |
| dehydration: how to rehydrate, what do you use? | orla rehydration solutions |
| When is oral rehydration solution recommended? | mild to moderate diarrhea |
| what does ORS do? | helps facilitate intestinal sodium and water absorption |
| What are the 2 phases of ORS? | rehydration therapy and maintinence therapy |
| What happens in rehydration therapy? | happens over 3-4 hours to replenish normal water and electrolyte imbalances |
| what happens in maintinence therapy? | maintaining normal body composition |
| When to avoid ORS? | in mild to moderate diarrhea |
| Dietary management: how long to withhold food | no longer than 24 hours |
| What is the BRAT diet, is it recommended? | bananas, rice, applesauce, toast and NOOOO |
| what can you do to prevent diarrhea? | isolate the diarrhea person, make them feel like a piriah, lol no im jk. wash hands, use steril techniques |
| Pharm therapy: what drugs can be used | loperamide, bismuth subsalycilate, attapulgite, kaolin, pectin and digestive enzymes, |
| what is the childrens dose for loperamide | 2mg caplet |
| what is the childrens dose for busmuth subsalycilate | 1 tablet or caplet (262 mg) or 262mg/15ml |
| what is the childrens dose for lactase? | tabs, caplets and liquids |
| what is the adult dose for loperamide? | 4mg initially, then 2mg after each loose stool and dont exceed 8mg a day |
| what is the adult dose for bismuth subsal | 525 every 30-60 up to 4200 mg a day |
| what is the adult dose for lactase? | 5-15 drops in a dairy product or 1-3 tabs or 1-2 caps with first bite of dairy product |
| Special populations: children under 6 what do you use | use ORT |
| Special populations: patients over 65 what do you use | dont self treat |
| Special populations: pregnant patients what do you use | refer and dont use BSS |
| Special populations: vomiting with gastroenteritis | BSS is preferred |
| probiotics when are they useful? | mild acute uncomplicated diarrhea |
| Zinc supplementation: what does it do? | may reduce duration and severity of acute diarrhea in young children |
| clinical pearls of loperamide: Max dose, when to avoid and side effects? | max dose: 8mg/day. Avoid: children under 6. Side effects: limited |
| clinical pearls of BSS: when to avoid, adverse effects | Avoid: children under 12, nursing or pregnant. Adverse effects: tinnitis, reyes syndrome, black staining of stool and tongue |
Created by:
carlypentland
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