Managing nausea in the hospitalised patient

Nausea is described as the unpleasant sensation of needing to vomit, while vomiting or emesis is the forceful oral expulsion of gastrointestinal (GI) contents. While vomiting may have a protective mechanism by removing potential harmful substances, nausea can result in significant debilitation and impact patient welfare. The possibility of nausea in an owner's cat or dog can result in owner distress and most owners are willing to pay for additional treatment for the clinical signs of nausea (Hay Kraus and Cazlan, 2019).

Nausea does not always result in vomiting, and is believed to be more challenging to manage than the act of vomiting (Morrow et al, 2002; Topal et al, 2005). There are numerous causes of nausea such as postoperative and anaesthesia-associated drugs including opioids and chemotherapeutics, and conditions affecting the brain, vestibular system and abdominal viscera. However, nausea is a subjective individual event and, while it is associated with numerous clinical signs, it may be difficult to truly interpret its full impact on a particular patient. Vomiting should not be misinterpreted as regurgitation, and therefore regurgitation will also be discussed. Registered veterinary nurses play a key role in identifying nauseous patients, administering antiemetics and providing additional supportive measures to decrease nausea in hospitalised patients.