Nausea is an unpleasant sensation in the throat, epigastric area, or abdomen that may cause a conscious desire to vomit but doesn’t always lead to vomiting.
Nausea may occur in relation to gastrointestinal problems like infection, overeating, acid reflux, obstruction, and more. Nausea may also be related to anxiety disorders, as a side effect of medications, pregnancy, or motion sickness. Central nervous system problems, metabolic disorders, and cardiovascular disorders can also cause nausea.
Nausea is subjective and is usually accompanied by anorexia or a lack of appetite. When nausea and vomiting occur for an extended period, dehydration and other complications can occur causing severe electrolyte imbalances, extracellular fluid volume loss, and circulatory failure.
The Nursing Process
In managing nausea, it is important to determine and treat its underlying cause, manage complications, and promote symptomatic relief.
A thorough assessment must be conducted to determine causative factors. Nurses can anticipate nausea in instances of chemotherapy and premedicate to prevent discomfort. Nurses can also educate patients on nonpharmacologic interventions to prevent and treat nausea.
Nursing Care Plans Related to Nausea
Nausea Care Plan
Nausea is a nursing-focused diagnosis as it is usually a secondary cause of a primary diagnosis.
Nursing Diagnosis: Nausea
Related to:
- Gastrointestinal problems
- Anxiety
- Noxious taste or smell
- Unpleasant sensory stimuli
- Exposure to toxins
- Alcohol intoxication
- Medication side effects
- Treatment or procedure like chemotherapy or radiation
- Pregnancy
- Motion sickness
- Increased intracranial pressure
- Pain
As evidenced by:
- Verbalization of nausea and urge to vomit
- Increased heart rate and respiration
- Cold, clammy skin
- Food aversion
- Increased swallowing
- Increased salivation
- Sour taste
- Gagging sensation
Expected Outcomes:
- The patient will verbalize relief from nausea
- The patient will be able to demonstrate strategies that prevent nausea
Nausea Assessment
1. Assess the possible causes and characteristics of nausea.
The cause of nausea can be treatment-related, physical, or situational. Establishing the reason for nausea can help with the development of an effective treatment plan.
2. Assess the patient’s hydration status.
Nausea causes aversion to food and fluids, thus there is a tendency for dehydration to occur due to fluid loss, especially if it is accompanied by vomiting.
Nausea Interventions
1. Provide the patient with routine oral care as needed.
Nausea is often associated with increased salivation and vomiting. Establishing routine oral care will decrease unpleasant feelings and odors in the mouth.
2. Eliminate offending smells from the room.
Strong odors can make nausea worse.
3. Offer ginger ale and dry snacks.
Ginger helps with settling the stomach. Bland foods such as crackers are likely to be tolerated and prevent nausea from an empty stomach.
4. Encourage the patient to eat small frequent meals.
Nauseated patients may not be able to tolerate large meals and they can be selective with the foods that they can tolerate. Small frequent meals can stabilize blood sugar levels, satisfy appetites, and provide nutrients throughout the day.
5. Encourage the patient to avoid spicy and greasy foods.
Heavily seasoned foods can irritate the stomach and contribute to nausea.
6. Administer antiemetics as indicated.
Antiemetic medications such as ondansetron or promethazine can help treat and prevent nausea.
7. Do not take medications on an empty stomach.
Educate patients that if their medications are causing nausea, try taking them with food if not contraindicated.
Risk for Deficient Fluid Volume Care Plan
Patients with nausea are at risk for deficient fluid volume as this symptom is often accompanied by vomiting. With vomiting, electrolyte imbalances can occur.
Nursing Diagnosis: Risk for Deficient Fluid Volume
Related to:
- Nausea and vomiting
- Difficulty meeting increased fluid volume requirement
- Inadequate knowledge about fluid needs
- Insufficient fluid intake
As evidenced by:
A risk diagnosis is not evidenced by any signs and symptoms, as the problem has not occurred yet and the nursing interventions will be directed at the prevention of symptoms.
Expected Outcomes:
- The patient will maintain hydration as evidenced by adequate intake and output, vital signs, and skin turgor
Risk for Deficient Fluid Volume Assessment
1. Assess the patient’s fluid status.
Signs of fluid volume deficit include non-elastic skin turgor, dry skin and mucous membranes, sunken eye appearance, hypotension, tachycardia, and low urine output.
2. Assess and monitor the patient’s intake and output.
Monitoring intake and output is one way for the nurse to assess adequate fluid intake.
3. Assess and monitor vital signs.
Hypotension can indicate a low vascular volume. An increase in heart rate can indicate a compensatory mechanism for low blood pressure. Fever can cause dehydration.
4. Monitor lab values.
Monitor electrolytes, hemoglobin and hematocrit, BUN, and creatinine as abnormalities in these labs can signal hydration issues.
Risk for Deficient Fluid Volume Interventions
1. Administer fluids intravenously as indicated.
Intravenous fluids may be indicated if oral fluid intake is inadequate in patients suffering from nausea and vomiting.
2. Offer high-water content foods.
Soups, popsicles, fruits, jello, and electrolyte-replacement drinks not only replace fluids but contain sodium, glucose, and other electrolytes.
3. Administer antiemetics as indicated.
Antiemetic medications can suppress the feeling of nausea, prevent vomiting, and will ultimately reduce fluid loss.
4. Encourage small sips of fluids or ice chips.
Nausea may cause a strong aversion to food and fluids, but small sips or ice chips may be tolerated.
Imbalanced Nutrition: Less than Body Requirements Care Plan
Nausea tends to limit the adequacy of nutritional intake. Aversion to food and loss of appetite can mean that the patient is not getting enough fluids through food sources which can lead to dehydration and malnutrition.
Nursing Diagnosis: Imbalanced Nutrition
Related to:
- Altered taste perception
- Food aversion
- Inadequate interest in food
- Difficulty swallowing
As evidenced by:
- Food intake less than recommended daily allowance (RDA)
- Nausea and vomiting
- Body weight below ideal weight range for age and gender
- Hypoglycemia
- Lethargy
- Pale mucous membranes
- Abdominal discomfort
- Hyperactive bowel sounds
- Abnormal nutritional lab values
Expected Outcomes:
- The patient will exhibit balanced nutrition as evidenced by the absence of malnutrition
- The patient will regain and maintain adequate body weight for age and gender
Imbalanced Nutrition: Less than Body Requirements Assessment
1. Assess and monitor the patient’s weight.
Many patients tend to lose weight unintentionally and suddenly during vomiting. Sustained vomiting may cause the body to lose important nutrients.
2. Assess and monitor for signs of malnutrition.
Patients who suffer from nausea may not eat nutritionally-balanced meals and are at risk for malnutrition. Signs of malnutrition include rapid unintentional weight loss, fatigue, weakness, poor concentration, brittle hair and nails, and decreased immunity.
3. Assess for tooth decay or thrush.
Nausea and subsequent vomiting may cause painful mouth sores, throat irritation, or tooth decay that makes eating uncomfortable.
Imbalanced Nutrition: Less than Body Requirements Interventions
1. Provide calorie-dense foods.
Patients who can only ingest small amounts of food can benefit from eating foods they prefer that are high in calories to increase overall caloric intake.
2. Create a pleasant environment conducive to eating.
Strong and offensive odors can cause nausea and vomiting. Provide uninterrupted time to eat and do not rush.
3. Premedicate with antiemetics.
Patients undergoing chemotherapy or radiation may require premedication to prevent the common side effect of nausea.
4. Implement tube feedings.
Patients unable to eat due to nausea may require enteral or parenteral nutrition to obtain necessary nutrients.
References and Sources
- Everything You Should Know About Nausea. Healthline. Medically reviewed by Saurabh Sethi, M.D., MPH — Written by Rachel Nall, MSN, CRNA — Updated on April 30, 2019. https://www.healthline.com/health/nausea
- Feeling sick (nausea). NHS. Page last reviewed: 12 May 2021. https://www.nhs.uk/conditions/feeling-sick-nausea/
- Nausea. Johns Hopkins Medicine. 2022. https://www.hopkinsmedicine.org/health/conditions-and-diseases/nausea
- Nausea and Vomiting. WebMD. Medically Reviewed by Minesh Khatri, MD on December 06, 2020. https://www.webmd.com/digestive-disorders/digestive-diseases-nausea-vomiting
- Takov V, Tadi P, Doerr C. Motion Sickness (Nursing) [Updated 2021 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568771/
