F7 · Vomiting
Actual Food and fluids
Definition
Repeated throwing up that may lead to fluid loss, weakness, and poor intake.- Stomach infection
- medicines
- blockage
- pregnancy
- chemotherapy
- Repeated throwing up
- nausea
- dry mouth
- weakness
- weight loss
📋 Scenario
A patient on chemotherapy vomits four times after dinner.
Subjective (S): "I keep throwing up and can't keep anything down."
Objective (O): Vomited four times in 3 hours; dry mouth; weight down 1 kg; pulse 102/min; on chemotherapy.
Assessment tools for this scenario: CP-FLUID Fluid Balance & Nutrition Score
Validated scales to consider: MUST, fluid chart, glucose
**CarePath diagnosis:** Vomiting related to chemotherapy, as evidenced by four episodes of vomiting in 3 hours, dry mouth, and a pulse of 102/min.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Give anti-sickness medicine as ordered. | Anti-sickness medicine blocks nausea signals, which stops further vomiting and helps keep fluids down. |
| Keep upright. | An upright position lowers the risk of vomit entering the lungs and eases nausea. |
| Offer small sips. | Small sips are easier to keep down than large drinks and start replacing lost fluid. |
| Protect skin and airway. | Vomit irritates skin and can block the airway if the patient is weak, so keeping skin clean and the airway clear prevents harm. |
| Record amounts. | Recording amounts shows how much fluid is lost and helps decide how much to replace. |
| Replace fluids. | Replacing fluids corrects the water and salt lost through repeated vomiting. The route follows the doctor's orders. |
| Give mouth care. | Vomiting leaves a sour taste and can damage the mouth lining, so mouth care adds comfort and protects it. |
**Expected outcomes**
- Within 24 hours: vomiting stops or falls to once a day or less, takes sips without nausea, hydration signs normal.
- Patient reports less nausea.
**Linking the data to the diagnosis**
The patient is on chemotherapy and vomited four times in 3 hours. The nurse finds a dry mouth, weight down 1 kg and pulse 102/min. He says he keeps throwing up and cannot keep anything down. This is an actual problem because the vomiting is already happening. Dehydration could follow, but it has not been shown here, so this statement is the main one. The plan aims for vomiting to stop or fall to once a day or less within 24 hours, sips taken without nausea, normal hydration signs and less nausea reported by the patient.
CarePath diagnosis
Vomiting related to chemotherapy, as evidenced by four episodes of vomiting in 3 hours, dry mouth, and a pulse of 102/min.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Give anti-sickness medicine as ordered. | Anti-sickness medicine blocks nausea signals, which stops further vomiting and helps keep fluids down. |
| 2. Keep upright. | An upright position lowers the risk of vomit entering the lungs and eases nausea. |
| 3. Offer small sips. | Small sips are easier to keep down than large drinks and start replacing lost fluid. |
| 4. Protect skin and airway. | Vomit irritates skin and can block the airway if the patient is weak, so keeping skin clean and the airway clear prevents harm. |
| 5. Record amounts. | Recording amounts shows how much fluid is lost and helps decide how much to replace. |
| 6. Replace fluids. | Replacing fluids corrects the water and salt lost through repeated vomiting. The route follows the doctor's orders. |
| 7. Give mouth care. | Vomiting leaves a sour taste and can damage the mouth lining, so mouth care adds comfort and protects it. |
Expected outcomes
- Within 24 hours: vomiting stops or falls to once a day or less, takes sips without nausea, hydration signs normal.
- Patient reports less nausea.
Linking the data to the diagnosis
The patient is on chemotherapy and vomited four times in 3 hours. The nurse finds a dry mouth, weight down 1 kg and pulse 102/min. He says he keeps throwing up and cannot keep anything down. This is an actual problem because the vomiting is already happening. Dehydration could follow, but it has not been shown here, so this statement is the main one. The plan aims for vomiting to stop or fall to once a day or less within 24 hours, sips taken without nausea, normal hydration signs and less nausea reported by the patient.