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Management of nausea and vomiting in children
1Indiana University School of Nursing, Indianapolis 46202, USA.
Insights
Nurses play a key role in managing pediatric nausea and vomiting (N/V) from anesthesia or chemotherapy. This involves understanding N/V pathways and using pharmacological and nonpharmacological interventions to ensure child comfort and well-being.
Area of Science:
- Pediatric Nursing
- Pharmacology
- Child Psychology
Background:
- Nausea and vomiting (N/V) are common, distressing side effects in children undergoing anesthesia or chemotherapy.
- These symptoms can lead to serious complications such as dehydration, weight loss, and emotional distress.
Purpose of the Study:
- To describe the physiological pathways of nausea and vomiting in children.
- To identify effective pharmacological and nonpharmacological interventions for managing pediatric N/V.
Main Methods:
- Review of physiological mechanisms underlying the vomiting center stimulation.
- Discussion of various medication classes used for N/V control.
- Exploration of nonpharmacological comfort measures.
Main Results:
- Understanding N/V pathways allows for targeted intervention.
- Pharmacological options include phenothiazines, substituted benzamide, corticosteroids, benzodiazepines, antihistamines, and serotonin antagonists.
- Nonpharmacological strategies encompass anxiety reduction, music therapy, hypnosis, relaxation, dietary changes, and acupressure.
Conclusions:
- Comprehensive management of pediatric N/V requires a multi-faceted approach.
- Integrating pharmacological and nonpharmacological methods optimizes comfort and minimizes adverse effects.
- Nurses are central to implementing these interventions effectively.
Abstract:
When children experience nausea and vomiting (N/V) as side effects of anesthesia or chemotherapy, a major role for nurses is to promote comfort. In addition to the discomfort of N/V in children, other detrimental effects include dehydration, weight loss, fluid and electrolyte imbalance, and emotional distress. This article describes the physiological pathways through which the vomiting center is stimulated to cause nausea and vomiting and identifies appropriate interventions for blocking these pathways using both pharmacological and nonpharmacological means. Medications used to control nausea and vomiting, including phenothiazines, substituted benzamide, corticosteroids, benzodiazepines, antihistamines, and serotonin antagonists, are discussed. Nonpharmacological interventions that are described include reducing anxiety, music therapy, hypnosis, progressive muscle relaxation, dietary modifications, and acupressure.