Nausea is an unpleasant sensation of discomfort in the stomach that may be accompanied by a feeling of urgency to vomit or to empty the stomach, along with or without vomiting. It is a common symptom of many illnesses and can affect a person's lifestyle and activity level. Nausea can be caused by numerous etiological factors, either physical or psychological, such as ingestion of toxic substances, pregnancy, motion sickness, stress, infections, and certain medications. Nausea and vomiting can lead to a lack of energy and appetite, dehydration, and malnutrition due to decreased food intake. It is important for nurses to recognize and assess signs of nausea and to provide appropriate interventions.
Nursing Diagnosis Definition
Nausea is defined as "an unpleasant, wavelike sensation in the back of the throat, epigastrium, or abdomen that may or may not result in vomiting." This definition emphasizes the subjective experience of the individual and highlights the variability of the symptom in terms of intensity, duration, and associated features.
Defining Characteristics
Subjective
- Reports feeling nauseated
- Complains of an upset stomach
- Complains of abdominal cramps
- Describes being uncomfortable or feeling ill
- Expresses a strong desire to avoid certain food odors
Objective
- Reports rate or intensity of nausea
- Experiences visual disturbances
- Demonstrates pallor around eyes or mouth
- Reports poor appetite
- Retches or vomits
Related factors are the underlying conditions or situations that contribute to the development of a nursing diagnosis. For nausea, some related factors may include:
- Medication side effects
- Chemotherapy or radiation therapy
- Gastrointestinal disorders, such as gastroenteritis or gastritis
- Pregnancy or hormonal changes
- Anxiety or stress
- Motion sickness or vestibular disorders
- Postoperative recovery
At Risk Population
Persons of any age are at risk for developing nausea, although infants and young children are more likely to experience recurrent episodes due to their immature digestive systems. In addition, people who are pregnant, on long-term medications, undergoing chemotherapy and radiation treatment, receiving dialysis, or who have other chronic medical conditions are at greater risk of developing nausea.
Associated Conditions
Nausea is often associated with other conditions such as vomiting, abdominal pain and bloating, loss of appetite, poor digestion, constipation, and fatigue. If not treated promptly, nausea may lead to dehydration and electrolyte imbalance, which can be life threatening.
Suggestions of Use
When using the nursing diagnosis of nausea, it is important to gather a comprehensive history and physical assessment to identify the underlying cause and contributing factors. It is also important to monitor the individual's response to interventions and adjust the care plan as needed. Some suggested interventions for nausea may include:
- Administering antiemetic medications as prescribed
- Encouraging small, frequent meals or snacks
- Providing oral care to reduce the sensation of a bad taste in the mouth
- Promoting rest and relaxation techniques, such as deep breathing or guided imagery
- Facilitating referrals to other healthcare providers, such as a gastroenterologist or psychologist
Suggested Alternative Nursing Diagnoses
If the individual's symptoms do not fully match the defining characteristics of nausea, there may be alternative nursing diagnoses to consider. Some suggested alternative nursing diagnoses may include:
- Risk for Imbalanced Nutrition: Less Than Body Requirements related to decreased food intake
- Anxiety related to fear of vomiting or underlying medical condition
- Risk for Fluid Volume Deficit related to vomiting or decreased oral intake
Usage Tips
When managing nausea, it is important for nurses to consider the physical effects of vomiting and the psychological effects of being unable to eat or drink. Nurses should provide patient education in order to help the patient identify triggers and adapt lifestyle changes that can help minimize the risk of nausea recurrence.
NOC Outcomes
Nursing interventions must produce measurable outcomes in order to evaluate their effectiveness. Appropriate NOC outcomes for a person experiencing nausea include:
- Respiratory Status: Ventilation: The ability to maintain a normal respiratory rate and pattern despite the development of nausea.
- Hydration: Adequate hydration status and measured intake of fluids.
Comfort Level: The patient’s perception of comfort or ease. - Nutrition: Less than Body Requirements: A decreased intake of nutrients that can be attributed to nausea symptoms.
- Health Maintenance: The patient’s ability to seek and utilize health care strategies relevant to the management of nausea.
- Activity Intolerance: The inability to tolerate physical activity due to fatigue, headache, dizziness, or other nausea symptoms.
Evaluation Objectives & Criteria
Specific objectives and criteria should be set in order to evaluate the effectiveness of nurse interventions and analyze whether the desired outcome has been achieved. Examples of evaluation objectives and criteria for nausea include:
- Symptom resolution/reduction
- Improved level of comfort/ability to tolerate activity
- Improved hydration
- Improved diet/increased nutrient intake
- Increased knowledge of disease/self-care strategies
- Ability to self-administer medications
NIC Interventions
Interventions used in the care of a patient with nausea should fall within the scope of criteria established by The National Institute of Nursing Research (NINR).
NINR Nursing interventions include:
- Provide/promote balanced nutrition
- Administer medications as prescribed
- Establish/maintain basic comfort measures
- Monitor/document patient responses
- Provide emotional support
- Encourage activity within limited tolerance
- Teach self-care strategies
- Develop a plan of care with the patient
Nursing Activities
In addition to providing appropriate nursing interventions, nurses should engage in a variety of activities to facilitate the care of a patient with nausea. Examples of nursing activities may include:
- Assessing the patient’s level of nausea, diet, nutrition and hydration status
- Teaching nutrition/hydration/activity guidelines
- Teaching/encouraging relaxation techniques
- Facilitating access to appropriate resources
- Assisting the patient in identifying nausea triggers
- Providing emotional support
- Offering periodic distraction techniques and diversional activities
Conclusion
Nausea is a common symptom of many illnesses and can be caused by several etiological factors. Nursing interventions should focus on identifying and addressing the cause of nausea, as well as providing appropriate interventions to reduce the severity or frequency of the symptom. In addition, nurses should provide supportive care and encourage the patient’s involvement in self-care strategies.
FAQs
Q. What is Nausea?
A. Nausea is an unpleasant sensation of discomfort in the stomach that may be accompanied by a feeling of urgency to vomit or to empty the stomach, along with or without vomiting.
Q. What are some causes of Nausea?
A. Potential causes of nausea include food poisoning, food allergies, emotional stress, medications, infections, chemical toxins, radiation therapy, gastric reflux, and pregnancy.
Q. Who is at risk of developing Nausea?
A. Persons of any age can experience nausea, however infants and young children, pregnant women, and those on long-term medications or with chronic diseases are especially at risk.
Q. How can Nausea be managed?
A. Nausea can be managed with interventions that reduce the severity or frequency of the symptom. These interventions may include relaxation techniques, having a light snack, avoiding food odors, avoiding activities that may increase nausea, taking medications such as antiemetics, exercising regularly, drinking plenty of fluids, and eating frequent small meals.
Q. What are acceptable Nursing Outcomes for Nausea?
A. Nursing outcomes for persons with nausea should include improved respiratory status, comfort level, hydration, nutrition, health maintenance, and activity intolerance.