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Nausea & Vomiting

Kristin Wong & Cara Kerr, Baylor University Louise Herrington School of Nursing

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Definitions

• Nausea is an uneasiness of the stomach that comes with the urge to vomit, but doesn't always lead to vomiting.
• Vomiting is the forcible emptying ("throwing up") of stomach contents through the mouth.
• When a baby throws up a little after eating and does not feel bad it is not the same as vomiting.
• Nausea and vomiting are not diseases, but symptoms of many different conditions, such as infection ("stomach flu"), food poisoning, motion sickness, over-eating, blocked intestine, appendicitis, illness, concussion or brain injury, appendicitis, migraine headache and many other problems.
• Nausea and vomiting are usually from a stomach infection and go away after a day or two. If they last longer or cannot be controlled, see a doctor or nurse practitioner.

Treatment

• Vomiting usually goes away in 6 to 24 hours, and may be treated at home.
• It is very important to get lots of water to replace what has been vomited. There is more risk for children to get dehydrated than adults.
• Take cool, bland fluids such as popsicles, jello, Gatorade, other "sports drinks" until bland food can be eaten (such as saltine crackers or plain bread).
• If symptoms have stopped after 24 hours of clear liquids, try full liquids such as soups, soft boiled eggs can be taken) and gradually work up to a bland diet (toast, bananas, cottage cheese, rice, boiled chicken).
• Eat small frequent meals rather than three large meals
• Avoid citrus drinks (orange juice/grapefruit juice), milk, spices, fatty foods and raw vegetables until feeling well.
• See a doctor or nurse practitioner if:
  • Child is under 6 years of age and vomiting lasts more than a few hours, diarrhea + vomiting lasts more than 24 hours, there are signs of dehydration, fever is higher than 100 Fahrenheit, or no urine in 6 hours.
  • Child is over 6 years and vomiting lasts more than 24 hours, here are signs of dehydration, fever is higher than 102 Fahrenheit, or no urine in 6 hours.
  • Adult if vomiting for more than 24 hours, diarrhea and vomiting for more than 24 hours, or if there is dehydration not helped by increased fluids. Seek help if nausea lasts more than one week, or if there is a possibility of pregnancy.
  • Anyone if home treatment is not working, dehydration is present, or a known injury has happened (head injury, infection).
• Go to clinic or Emergency Department immediately if the following occur:
  • Blood in the vomit ("coffee grounds" appearance)
  • Severe headache or stiff neck
  • Lethargy
  • Confusion
  • Decreased alertness
  • Severe abdominal pain
  • Vomiting with fever over 101 degrees Fahrenheit
  • Vomiting and diarrhea are both present (see above)
  • Rapid breathing or pulse
• Medications for nausea and vomiting are usually not recommended. Preventing dehydration is the most important thing to do. Bismuth subsalicylate (like Pepto-Bismol) may help nausea with or without diarrhea. Other effective medicines require a prescription.
• Treat fever with acetaminophen, sponge bath with warm water (not alcohol), and cool cloth to the head if it feels good to the child.