Difference between revisions of "Nausea and vomiting"

(Disposition)
 
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''This page is for adult patients; for pediatric patients see [[nausea and vomiting (peds)]]''
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{{Adult top}} [[nausea and vomiting (peds)]].''
 
==Background==
 
==Background==
 
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]]
 
[[File:Nausea_and_vomiting.png|thumb|Nausea and Vomiting Algorithm]]
  
 
==Clinical Features==
 
==Clinical Features==
 
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*Nausea and/or vomiting
 +
*Additional features of underlying process
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
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====GI====
 
====GI====
 
*[[Peptic ulcer disease]]
 
*[[Peptic ulcer disease]]
*Obstruction
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*[[Bowel obstruction|Obstruction]]
 
**Adhesion
 
**Adhesion
 
**[[Small bowel obstruction]]/LBO
 
**[[Small bowel obstruction]]/LBO
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*[[Migraine]]
 
*[[Migraine]]
 
*[[Labyrinthitis]]
 
*[[Labyrinthitis]]
*[[Meniere disease]]
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*[[Meniere's disease]]
 
*[[Motion sickness]]
 
*[[Motion sickness]]
 
*[[Cannabinoid hyperemesis syndrome]]
 
*[[Cannabinoid hyperemesis syndrome]]
  
 
====Infectious====
 
====Infectious====
*Bacterial toxins
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*[[Bacteria]]l toxins
 
*[[Pneumonia]]
 
*[[Pneumonia]]
 
*[[SBP]]
 
*[[SBP]]
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====Endocrine====
 
====Endocrine====
*[[Pregnancy]]
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*[[Pregnancy]], [[hyperemesis gravidarum]]
 
*[[Hyponatremia]]
 
*[[Hyponatremia]]
 
*[[Adrenal insufficiency]]
 
*[[Adrenal insufficiency]]
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*APAP, ASA, digoxin levels
 
*APAP, ASA, digoxin levels
 
*[[Urinalysis]]
 
*[[Urinalysis]]
*?Abdominal xray
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*?[[Abdominal xray]]
 
*?CT
 
*?CT
 
*?[[Ultrasound]]
 
*?[[Ultrasound]]
  
 
==Management==
 
==Management==
 
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*Treat underlying pathology
 +
*Address [[electrolyte derangements]] and [[dehydration]] as needed
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*[[Antiemetics]]
  
 
==Disposition==
 
==Disposition==
 
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*Depends on cause
 +
*Most non-specific episodes of acute nausea and vomiting may be discharged, if:
 +
**No emergent/urgent cause identified or suspected
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**Patient tolerating fluids after treatment
  
 
==Complications==
 
==Complications==
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==External Links==
 
==External Links==
 
  
 
==References==
 
==References==

Latest revision as of 05:59, 14 May 2020

This page is for adult patients. For pediatric patients, see: nausea and vomiting (peds).

Background

Nausea and Vomiting Algorithm

Clinical Features

  • Nausea and/or vomiting
  • Additional features of underlying process

Differential Diagnosis

Nausea and vomiting

Critical

Emergent

Nonemergent

By organ system

GI

Neurologic

Infectious

Drugs/Toxins

Endocrine

Miscellaneous

Evaluation

Varies widely depending on clinical presentation

Management

Disposition

  • Depends on cause
  • Most non-specific episodes of acute nausea and vomiting may be discharged, if:
    • No emergent/urgent cause identified or suspected
    • Patient tolerating fluids after treatment

Complications

See Also

External Links

References