Nausea and vomiting: end-of-life assessment and management

Abstract

Nausea and vomiting affect 40–70% of patients with advanced cancer. Both conditions diminish quality of life significantly, particularly in relation to intractable nausea and vomiting. This article discusses key management issues of a woman in the advanced stages of her disease (see Case scenario box) admitted to hospital suffering from nausea and vomiting of complex origin. It highlights how the symptom of nausea may be disregarded in comparison to the visible sign of vomiting. It examines associated neurophysiology, assessment, pharmacological and non-pharmacological interventions and the psychological distress caused by nausea and vomiting. It is acknowledged that nurses will generally not be involved in prescribing decisions. However, they should understand the problems associated with managing nausea and vomiting and that various antiemetics have different effects. The importance of raising awareness of the hidden nature of nausea is highlighted. To maintain confidentiality, the name and some of the details of the person concerned have been changed (Nursing and Midwifery Council, [2008][1]). Conflicts of interest: none [1]: #ref-33