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 2023/02/07 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