Nausea And Vomiting Flashcards
What does coffee ground in vomit indicate
May indicate upper GI bleeding
But always try to verify and look fir other evidence
What does recognisable food indicate in vomit
Gastric stasis potentially
Feculant vomit (faeces)
GI obstruction
What does vomiting in the morning indicate
Potential al pregnancy
Inc ICP
What goes vomiting approx 1hour post-food indicate
Gastric stasis/gastroparesis
Gastroparesis cause by damage to the vagus nerve such as in DM due to potential high glucose levels
What is indicated if the vomiting relieves pain
Peptic ulcer
What is indicated if the vomiting is preceded by a loud gurgling
GI obstruction
What blood tests should be done in N&V
FBC U&E LFT Ca2+ Glucose Amylase ABG metabolic alkalosis from loss of gastric contents -severe vomiting Plain AXR - bowel obstruction Upper GI endoscopy - suspicion of bleed or persistent vomiting Consider head CT in case of inc ICP
Treatment for N&V
Treat underlying causes
Symptomatic relief - antiemetic may need more than one
Give IV fluids
With k+ replacement if severely dehydrated of NBM
Monitor electrolyte and fluid balance
H1 receptor antagonist
Cyclizine
Cinnarizine
D2 receptor antagonists
Metocloperamide
Domperidone
Procholperazine
Haloperidol
5HT receptor antagonist
Ondansetron
Drugs that affect other pathways to prevent vomiting
Hyosine hydrobromide
Dexamethasone
Midazolam
What is cyclizine given for
GI causes
What is cinnarizine given for
vestibular disorders
