RT Book, Section
A1 Gravatt, Leigh Anne Hylton
A1 Donohoe, Krista L.
A1 DiPiro, Cecily V.
A2 DiPiro, Joseph T.
A2 Talbert, Robert L.
A2 Yee, Gary C.
A2 Matzke, Gary R.
A2 Wells, Barbara G.
A2 Posey, L. Michael
SR Print(0)
ID 1154960474
T1 Nausea and Vomiting
T2 Pharmacotherapy: A Pathophysiologic Approach, 10e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259587481
LK accesspharmacy.mhmedical.com/content.aspx?aid=1154960474
RD 2022/01/20
AB Patient  Care  Process  for  Nausea  and  VomitingCollectPatient  characteristics  (e.g.,  age,  sex,  pregnancy  status,  triggers)Patient  medical  history  (personal  and  family),  history  of  NVSocial  history  (e.g.,  tobacco/ethanol/cannabis  use)  and  dietary  habitsCurrent  medications  including:  prescription,  non-rescription,  herbal  products,  dietary  supplementsObjective  data  (e.g.,  QTc  prolongation,  BP/pulse,  complete  metabolic  panel,  CBC,  liver  function,  weight,  skin  turgor,  urine  output)AssessDuration,  frequency,  severity  of  nausea  and  vomitingAbility/willingness  to  pay  for  treatment  optionsEmotional  status  (e.g.,  presence  of  anxiety,  depression)Assess  ability  of  the  patient  to  use  oral,  rectal,  injectable,  or  transdermal  medicationsSuccess  of  previous  antiemetic  regimensFor  CINV:  Assess  emetic  risk  of  chemotherapy  (see  Table  35-2)For  PONV:  Assess  risk  factors  for  developing  PONV  (see  Table  35-5)Plan*Drug  therapy  regimen  including  specific  antiemetic(s),  dose,  route,  frequency,  and  duration  (see  Tables  35-3,  35-6)Monitoring  parameters  including  efficacy  (e.g.,  reduction  in  symptoms,  resolution  of  laboratory  test  abnormalities,  resumption  of  normal  oral  intake)  and  safety  (e.g.,  QTc  prolongation,  drug-drug  interactions);  frequency  and  timing  of  follow-upPatient  education  (e.g.,  purpose  of  treatment,  dietary  and  lifestyle  modification,  invasive  procedures,  drug-specific  information,  medication  administration  technique)Self-monitoring  for  resolution  of  symptoms,  when  to  seek  emergency  medical  attentionReferrals  to  other  providers  when  appropriate  (e.g.,  gastroenterologist,  dietitian,  OBGYN,  oncologist,  anesthesiologist)Implement*Provide  patient  education  regarding  all  elements  of  treatment  planUse  motivational  interviewing  and  coaching  strategies  to  maximize  adherenceSchedule  follow-up,  adherence  assessmentFollow-up:  Monitor  and  EvaluateResolution  of  nausea  and  vomiting  symptomsEvaluate  need  for  rescue  antiemeticsPresence  of  adverse  effectsPatient  adherence  to  treatment  plan*Collaborate  with  patient,  caregivers,  and  other  health  professionals