5 Nursing Care Plans For Nausea with Interventions and Examples

Introduction

Nausea is a symptom everyone dreads. You’ve almost certainly experienced that queasy feeling at one time or another — perhaps while reading a book in a moving vehicle, or maybe after eating something that didn’t agree with you.

Whatever the cause, “nausea” is a term that describes the uneasy feeling in the stomach that means you might have to vomit.

This blog post discusses about nausea; its symptoms, causes, nursing care plans and interventions with some examples .As you follow along, remember that our qualified writers are always ready to help in any of your nursing assignments. All you need to do is place an order with us!

Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Signs and Symptoms of Nausea

Generally, when experiencing nausea, one feels sick in the stomach.

Other signs and symptoms of nausea:

  • Weakness
  • Sweating
  • A buildup of saliva in your mouth
  • Urge to vomit

Causes of Nausea

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5 Nursing Care Plans For Nausea with Interventions and Examples 6

Two of the most common causes of nausea and vomiting are stomach flu (viral gastroenteritis) and food poisoning.

Other common causes of nausea include:

  • Early stages of pregnancy in women
  • Seasickness and other forms of motion sickness
  • Severe pain
  • Being exposed to chemical toxins
  • Emotional stress, such as fear
  • Gallbladder disease
  • Indigestion
  • Particular smells or odors
  • Several medications can also cause nausea. General anesthesia can also make you feel nauseated.

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Diagnosis of Nausea

To determine what’s causing nausea, a doctor will take the medical history, ask about the symptoms, and conduct a physical exam. They will also look for signs of dehydration and may administer some tests, including blood, urine, and possibly a pregnancy test.

Duration of Nausea

How long nausea lasts depends on the cause.

Nausea and vomiting from stomach flu will usually start to get better within 24 hours.

Nausea and vomiting from food poisoning may take up to 48 hours to resolve.

Treatment and Medication Options for Nausea

Nausea can commonly be alleviated with self-care measures that are low risk yet have variable research evidence. The following tips can be helpful:

  • Get some rest. Being too active can make nausea worse.
  • Stay hydrated. Drink cold, clear, carbonated, or sour beverages, such as ginger ale, lemonade, and water, and try to take small sips. Mint tea may also help calm nausea. Oral rehydration solutions like Pedialyte can prevent dehydration.
  • Steer clear of strong odors. Food and cooking smell, perfume, and smoke can be triggers.
  • Avoid other triggers. Other nausea and vomiting triggers include stuffy rooms, heat, humidity, flickering lights, and driving.
  • Eat bland foods. If you’ve been vomiting, wait some time to eat solid foods until your body feels ready. When you think you can tolerate solids, start with foods like rice, crackers, toast, applesauce, and bananas, which are easy to digest. When you can keep these down without vomiting (if you’ve been vomiting or feel like you might), try cereal, rice, fruit, and salty or high-protein, high-carbohydrate foods.
  • Avoid fatty or spicy foods. These foods can make your nausea worse.

Other helpful tips that may help control nausea include:

  • Don’t combine hot and cold foods.
  • Drink beverages slowly.
  • Avoid brushing your teeth after you eat.
  • To stave off vomiting, you could try taking small sips of clear, carbonated beverages or fruit juices (except orange and grapefruit, which are too acidic) or suck on popsicles.
  • To avoid or reduce motion sickness in a car, sit facing the front windshield (watching fast movement out the side windows can make nausea worse).

Medication Options

  • Dimenhydrinate (Dramamine)
  • Meclizine (Travel Sickness)
  • Chewable or liquid antacids
  • Bismuth sub-salicylate (Pepto-Bismol)
  • A solution of glucose, fructose, and phosphoric acid (Emetrol)

If these medications don’t help you feel better, various oral prescription medications are also used for nausea, with various efficacy and side effects. Prescription motion sickness adhesive patches like scopolamine (Transderm Scop) may also be helpful for long trips, like a cruise.

Prevention of Nausea

  • Have smaller meals more often throughout the day instead of three large meals
  • Eat slowly
  • Avoid foods that are difficult to digest
  • Eat foods that are cold or at room temperature
  • Rest after you eat and keep your head elevated about 12 inches above your feet
  • If you feel nauseated when you wake up, eat a few crackers before getting out of bed or have a high-protein snack (lean meat or cheese) before bedtime.
  • Avoid excessive drinking of liquids during meals.
  • Drink at least six to eight 8-ounce glasses of water a day to prevent dehydration
  • Wait to eat until you’re feeling less nauseated.

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Complications of Nausea

If nausea leads to or is accompanied by vomiting, one may become dehydrated.

Children have a greater risk of becoming dehydrated, mainly when vomiting occurs with diarrhea, because they may not notice or be able to tell an adult that they are experiencing symptoms of dehydration, such as being thirsty. If you’re caring for a sick child, be on the lookout for these signs of dehydration:

  • Dry mouth and lips
  • Sunken eyes
  • Rapid breathing or pulse
  • In infants, less frequent urination and a sunken fontanel (soft spot on top of the baby’s head)

Nursing Care Plans For Nausea

Nursing Care Plan 1: Cancer with Ongoing Chemotherapy

Nursing Diagnosis: Nausea and Vomiting related to chemotherapy status secondary to cancer as evidenced by reports of nausea, vomiting, and gagging sensation.

Desired Outcome

The patient will manage chronic nausea, as evidenced by maintaining or regaining weight.

InterventionRationale
Assess the extent of nausea, vomiting, and limited food and fluid intake.To provide baseline data and determine the need for hydration and nutritional support.
Encourage to try dry foods (crackers, toast) when nausea occurs.To decrease discomfort and enhance intake.
Encourage ice chips, sips of cold water, and ginger products when nauseous.To promote hydration and decrease the discomfort associated with nausea.
Promote a bland diet and decrease intake of greasy and spicy food and caffeinated beverages. Avoid milk/dairy products overly sweet, fried, and fatty foods.To reduce gastric acidity, improve nutrient intake, and prevent further nausea and vomiting.
Administer antiemetics regularly before, during, and after administration of antineoplastic agents.To prevent and control side effects of the antineoplastic medications, including but not limited to nausea and vomiting.
 Monitor weight regularly.Monitor nutritional status throughout the chemotherapy and address malnutrition and dehydration if present.
Discuss possible complications with the healthcare team.Timely recognition of possible complications leads to timely solutions.
Educate the patient to avoid foods and smells that trigger nausea.To decrease the occurrence of nausea and vomiting.
Advise the patient on nonpharmacologic ways to reduce nausea, such as guided imagery, deep breathing exercises, and relaxation.To control and manage nausea and to promote independence.
Inform the patient and the caregiver to seek professional assistance if vomiting persists for more than 24 hours.Persistent vomiting has serious consequences. Timely assessment may prevent complications brought about by this condition, i.e., dehydration, electrolyte imbalance, and nutritional deficiencies.

Nursing Care Plan 2: Gallbladder Disease

Nursing Diagnosis: Nausea and Vomiting related to intestinal blockage secondary to gallbladder disease and intestinal obstruction as evidenced by nausea, vomiting, and gagging sensation.

Desired Outcome

The patient will be free of nausea.

InterventionRationale
Prepare the patient for diagnostic testing. To determine the etiology of nausea and vomiting.
Maintain oral hydration and start intravenous hydration as ordered.To prevent dehydration and hypovolemia.
Encourage to try dry foods (crackers, toast) when nausea occurs.To decrease discomfort and enhance nutritional intake.
Encourage ice chips, sips of cold water, and ginger products when nauseous.To promote hydration and decrease the discomfort associated with nausea.
Promote a bland diet and decrease intake of greasy and spicy food and caffeinated beverages. Avoid milk/dairy products overly sweet, fried, and fatty foods.To reduce gastric acidity, improve nutrient intake, and prevent further nausea and vomiting.
Advise the patient on nonpharmacologic ways to reduce nausea, such as guided imagery, deep breathing exercises, and relaxation.To control and manage nausea and to promote independence.
Administer antiemetics as needed, as ordered by the healthcare provider.To halt vomiting and prevent further vomiting episodes.
Administer pain medications as needed, as ordered by the healthcare provider.Pain may exacerbate vomiting episodes. Administering pain medications decreases the risk of further episodes.
Monitor the patient for signs and symptoms of complications.Timely recognition of complications leads to timely solutions.
Educate the patient to avoid foods and smells that may trigger nausea.To decrease the occurrence of nausea and vomiting.
Prepare the patient for pharmacologic and/or surgical interventions.To effectively alleviate nausea and vomiting being experienced by the patient.
Maintain the patient on a low-fat diet.Preventing gallstone formation prevents further episodes of nausea and vomiting due to gallbladder disease.

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Nursing Care Plan 3: Food Poisoning

Nursing Diagnosis: Nausea and Vomiting related to irritation of the gastrointestinal system as evidenced by abdominal cramping and abdominal pain secondary to food poisoning

Desired Outcome

The patient will be able to state relief of nausea and will be able to explain methods that can be used to decrease nausea and vomiting.

InterventionRationale
Determine the cause of nausea and vomiting (e.g., food poisoning). Determine the food source that caused nausea and vomitingNausea and vomiting are clinically identifiable symptoms, the cause needs to be determined, and appropriate plans and interventions be developed.
Document each episode of nausea and/or vomiting separately, as well as the effectiveness of interventions. The use of an assessment tool is needed for the consistency of evaluation.A systematic approach can provide consistency, accuracy, and measurement needed for the direction of care. It is essential to recognize that nausea is a subjective experience.
Identify and eliminate contributing causative factors. This would include eliminating the food source that has been identified as the cause of nausea and vomiting.Elimination of these contributing causative factors may provide the patient relief from a stimulus that causes nausea and vomiting.
Implement appropriate dietary measures such as nothing by mouth (NBM or NPO) status when appropriate; instituting small frequent meals; and implementing low-fat meals. It is beneficial to avoid spicy, fatty, or highly salty foods.Implementing an NPO status gives the gastrointestinal system of the patient time to recover from nausea and vomiting, and implementation of the different feeding arrangements ensures the adequate nutritional status of the patient.
Recognize and implement interventions and monitor complications associated with nausea and vomiting. This may include the administration of intravenous fluids and electrolytes.Recognizing the complications of nausea and vomiting is critical in preventing and managing the complications of dehydration, electrolyte imbalance, and malnourishment. Adequate hydration also corrects imbalances and reduces further emesis.
Administer appropriate antiemetics, according to emetic cause, by most effective route, with a consideration of the side effects of the medication, and with attention to and coverage for the timeframes that nausea and vomiting is anticipatedAntiemetic drugs are effective at different receptor sites and treat the different causes of nausea and vomiting. A combination of medications may be more effective than a single drug.

Nursing Care Plan 4: Pregnancy

Nursing Diagnosis: Nausea and vomiting related to pregnancy as evidenced by aversion to food and gagging sensation

Desired Outcome

The patient will be able to state relief of nausea and be able to explain methods the patient can use to decrease the incidence of nausea and vomiting.

InterventionRationale
Early recognition of pregnancy-induced nausea and vomitingEarly recognition and conservative measures are recommended to successfully manage nausea and vomiting caused by pregnancy and prevent the progression to hyperemesis gravidarum. 
Implement dietary and lifestyle modifications first before the implementation of pharmacological interventionsThe fetus is susceptible to pharmacological interventions. Dietary and lifestyle options should be tried first.
Avoidance of aversive odors or foods is recommended To avoid the stimulation of nausea and vomiting Eating multiple small meals per day To ensure adequate nutrition and to have food in the stomach at all times, thereby preventing hypoglycemia and gastric overdistentionDrinking smaller volumes of liquids at multiple times throughout the day Ensures adequate hydration without the stimulation of nausea and vomitingAssess and manage symptoms of heartburn, belching, and indigestion Due to the high incidence of coexisting gastroesophageal reflux disease (GERD) during pregnancy, it is important to address these symptoms should they occurTesting for Helicobacter pylori Helicobacter pylori is associated with hyperemesis gravidarum. It is recommended to test for Helicobacter pylori if there are persistent symptoms of nausea with pregnancy, prolonged symptoms of GERD, or a previous history of Helicobacter pylori infection. Timely diagnosis and treatment of anxiety and depression Coexisting psychosocial factors may also influence the severity of nausea and vomiting during pregnancy. Symptoms of anxiety and depression can occur in early pregnancy, especially when nausea and vomiting are severe, making the treatment of nausea and vomiting more challenging and even ineffective.
Administration of oral pyridoxine hydrochloride and doxylamine succinateThis combination is the first-line treatment for nausea and vomiting of pregnancy

Nursing Care Plan 5: Gastroenteritis

Nursing Diagnosis: Nausea and vomiting related to active fluid volume loss secondary to gastroenteritis

Desired Outcome

The patient will be able: to maintain a urine output of 0.5 mL/kg/hour or at least more than 1300 mL/day; maintain normal blood pressure, heart rate, and body temperature; maintain elastic skin turgor, moist tongue, and mucous membranes, and orientation to person, place, and time.

InterventionRationale
Watch for early signs of hypovolemia, including thirst, restlessness, headaches, and inability to concentrate.Thirst is often the first sign of dehydration. Heart rate increases due to fluid restriction along with increased urine specific gravity, darker urine color, and increased thirst. Decreased alertness, increased sleepiness, fatigue, and confusion are also experienced.
Recognize symptoms of cyanosis, cold, clammy skin, weak thready pulse, confusion, and oliguria as late signs of hypovolemiaThese symptoms occur after the body has compensated for the fluid loss by removing fluid from the interstitial space into the vascular compartment.
Monitor pulse, respiration, and blood pressure of patients with deficient fluid volume every 15 minutes to 1 hour for unstable patients and every 4 hours for stable patientsChanges in vital signs seen with fluid volume deficit include tachycardia, tachypnea, decreased pulse pressure, hypotension, decreased pulse volume, and reduced or increased body temperature.
Check orthostatic blood pressure with the patient standing, sitting, and lying.A decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within 3 minutes of standing compared with blood pressure from the sitting position is considered as orthostatic hypotension.
Note the skin turgor over bony prominences such as the hand or shinFor the assessment of the level of dehydration  
Weigh the patient daily and watch for sudden decreases, especially in the presence of decreasing urine output or active fluid lossBodyweight changes of 1 kg represent a fluid loss of 1 L
Monitor total fluid intake and output every 4 hours or every hour for unstable patients.To monitor the patient’s hydration status.
Provide fresh water and oral fluids preferred by the patientTo promote hydration
Administer pharmacologic interventions such as antibiotics, antivirals, antidiarrheals, and antiemetics as ordered and appropriateTo treat the cause of the gastroenteritis.

References

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