STUDY - Technical - New Dacian's Medicine
Nausea
(Classical / Allopathic Medicine)
Nausea, a common
symptom of GI disorders, is a sensation of profound revulsion
to food or of impending vomiting. Commonly accompanied by such
autonomic signs as hypersalivation, diaphoresis, tachycardia,
pallor, and tachypnea, it's closely associated with anorexia
and vomiting.
Nausea may occur
with a fluid or electrolyte imbalance, an infection, or a
metabolic, endocrine, labyrinthine, or cardiac disorder. It
may also be a result of drug therapy, surgery, or radiation.
Common during the first trimester of pregnancy, nausea may
also arise from severe pain, anxiety, alcohol intoxication,
overeating, or ingestion of distasteful food or liquids.
HISTORY:
Ask the patient to describe the onset, duration, and intensity of nausea as well as what provokes or relieves it.
Review the patient's medical history, noting especially GI, endocrine, and metabolic disorders; recent infections; and cancer (including its treatment).
Ask the patient about associated signs and symptoms, particularly vomiting (including color and amount), abdominal pain, anorexia, weight loss, changes in bowel habits or stool character, excessive belching or flatus, and a sensation of bloating.
If the patient is a female of childbearing age, ask whether she is or could be pregnant.
Ask the patient if he was recently exposed to someone with a GI disturbance.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about his diet.
Ask the patient to describe the onset, duration, and intensity of nausea as well as what provokes or relieves it.
Review the patient's medical history, noting especially GI, endocrine, and metabolic disorders; recent infections; and cancer (including its treatment).
Ask the patient about associated signs and symptoms, particularly vomiting (including color and amount), abdominal pain, anorexia, weight loss, changes in bowel habits or stool character, excessive belching or flatus, and a sensation of bloating.
If the patient is a female of childbearing age, ask whether she is or could be pregnant.
Ask the patient if he was recently exposed to someone with a GI disturbance.
Obtain a drug history, including prescription and over-the-counter drugs, herbal remedies, and recreational drugs. Also, ask the patient about alcohol intake.
Ask the patient about his diet.
PHYSICAL
ASSESSMENT:
Inspect the skin for jaundice, bruises, and spider angiomas, and assess skin turgor.
Inspect the abdomen for distention, auscultate for bowel sounds and bruits, palpate for rigidity and tenderness, and test for rebound tenderness.
Palpate and percuss the liver for enlargement.
Assess other body systems, as appropriate.
Inspect the skin for jaundice, bruises, and spider angiomas, and assess skin turgor.
Inspect the abdomen for distention, auscultate for bowel sounds and bruits, palpate for rigidity and tenderness, and test for rebound tenderness.
Palpate and percuss the liver for enlargement.
Assess other body systems, as appropriate.
SPECIAL
CONSIDERATIONS:
Herbal remedies, such as ginkgo biloba and St. John's wort, have certain adverse effects, including nausea. Postoperative nausea and vomiting are common, especially after abdominal surgery.
Herbal remedies, such as ginkgo biloba and St. John's wort, have certain adverse effects, including nausea. Postoperative nausea and vomiting are common, especially after abdominal surgery.
PEDIATRIC
POINTERS:
Nausea, frequently described as a stomachache, is one of the most common childhood complaints. Commonly the result of overeating, and nausea can occur from any one of several disorders, ranging from acute infection to a conversion reaction caused by fear.
Nausea, frequently described as a stomachache, is one of the most common childhood complaints. Commonly the result of overeating, and nausea can occur from any one of several disorders, ranging from acute infection to a conversion reaction caused by fear.
AGING ISSUES:
Elderly patients have increased dental caries; more frequent tooth loss; decreased salivary gland function, which causes mouth dryness; reduced gastric acid output and motility; and decreased senses of taste and smell. All of these may be factors contributing to nonpathologic nausea.
Elderly patients have increased dental caries; more frequent tooth loss; decreased salivary gland function, which causes mouth dryness; reduced gastric acid output and motility; and decreased senses of taste and smell. All of these may be factors contributing to nonpathologic nausea.
PATIENT
COUNSELING:
Tell the patient to breathe deeply to ease nausea. Advise him to keep his room fresh and clean-smelling by providing adequate ventilation.
Tell the patient to breathe deeply to ease nausea. Advise him to keep his room fresh and clean-smelling by providing adequate ventilation.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common symptoms,
Edition V, McGraw - Hill, 2002.