NURS 2514 > Week 5 - NV > Flashcards

Week 5 - NV Flashcards

(72 cards)

Study These Flashcards
1
Q

define nausea

A
  • a feeling of discomfort in the epigastrium with a conscious desire to vomit
  • the sensation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define vomiting

A
  • the forceful ejection of partially digested food & secretions from the upper GI tract
  • aka emesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what controls the sensation of nausea and action of vomitting?

A
  • the emetic center in the medulla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what happens once the emetic center receives enough stimulation

A
  • it will become active & you will get the sensation of nausea & action of vomitting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where does the emetic center receive input from? (4)

A
  1. the chemoreceptor trigger zone
  2. the vestibular system
  3. vagal & enteric nervous system
  4. the CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the chemoreceptor trigger zone (CTZ)?

A
  • an area of the medulla center that lies outside the blood brain barrier
  • it detects chemical stimuli in the blood such as hormones & drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does the CTZ have receptors for? (5)

A
  • dopamine
  • serotonin
  • opiates
  • acetylcholine
  • substance P
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the vestibular system

A
  • system inside the ear that helps maintain our posture, sense of balance
  • sends info to the brain via crnial nerve VIII (auditory nerve)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what kind of receptors are present in the vestibular system

A
  • muscarinic receptors (acetylcholine receptors) and histamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does the vestibular system play a major role in?

A

motion sickeness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe how motion sickness occurs? provide an example with sea sickness

A
  • due to a mismatch between vestibular and visual info
    ex. with sea sickness you look at the deck and it doesn’t look like your moving but your vestibular system detects movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does the vagal and enteric system receive info about?

A
  • it inputs transmit info regarding the state of the GI system
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what kinda receptors are present in the vagal & enteric nervous system?

A
  • serotonin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what activates the serotonin receptors in the vagal & enteric nervous system (4)

A

irritation of the GI by:

  • chemo
  • radiation
  • distension
  • acute infectious gastroenteritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the CNS mediates vomitting that arises from? provide 3 examples

A

things from higher brain centers:

  • psychiatric disorders
  • stress
  • when we see & smell someone else vomitting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are 5 causes of vomitting

A
  • causes in the digestive tract
  • sensory system & brain
  • pregnancy
  • drug reaction
  • illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are some examples of causes in the GI tract that cause vomiting (3)

A
  • gastritis
  • overeating
  • food poisoning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some examples of how the sensory system & brain cause vomiting? (3)

A
  • motion sickness
  • concussion
  • cerebral hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are some examples of how drug reactions can cause vomiting (4)

A
  • alcohol
  • opioids
  • selective serotonin reuptake inhibitors
  • chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is an example of an illness that causes vomitting

A
  • the stomach flu (gastric irritation caused by viruses or bacteria)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

list 3 complications of vomiting

A
  • aspiration
  • mallory-weiss tear
  • fluids & electrolytes abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is aspiration r/t vomiting

A
  • passage of gastric contents into the airways
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

list 2 reasons someone is at an increased risk of aspiration when vomiting

A
  • decreased LOC

- if vomiting for prolonged periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the mallory-weiss tear

A
  • a tear in the esophageal lining which causes GI bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what causes the mallory-weiss tear
- retching or dryheaving
26
list 4 fluids & electrolytes that vomiting effects
- loss of HCl - loss of K+ - increased production of HCO3- - dehydration
27
what is the alkaline tide
- when we lose HCl through vomiting, the body tries to restore the acid and HCO3- is made as a biproduct
28
what does the changes in fluid & electrolytes lead to (3)
- hypochloremia - hypokalemia - metabolic alkalosis
29
how is the metabolic alkalosis compensated
- decreased RR (to try to accumulate CO2)
30
what is metabolic alkalosis
- loss of H+ ions > excessive production of bicarb ions | = high pH, high HCO3-
31
what does prolonged vomiting result in
- switch from metabolic alkalosis to metabolic acidosi
32
what does the switch to metabolic acidosis indicate?
- even with continued loss of H+ ions, we are now getting more HCO3- losses than H+ losses
33
what are 2 causes of the switch to metabolic acidosis
1. physical losses of HCO3- | 2. chemical consumption of HCO3-
34
what is meant by physical losses of HCO3
- with prolonged vomiting, the place where secretions are lost digs deeper each time (start with stomach contents, then pylorus, then duodenom) - so, with prolonged vomiting we lose duodenal secretions which are rich in HCO3-
35
what is included as duodenal secretion
- pancreatic & small intestine secretions
36
what is chemical consumption of HCO3-
- hypovolemia & increased muscle activity associated with comiting results in lactic acid production - in addition, depletion of liver glucose stores & loss of ingested carbs could cause ketoacidosis - the bicarb is then used to buffer these acids & is "chemically consumed"
37
what are drugs that work for nausea & vomitting called
- antiemetics | - antinausea
38
what are 6 types of antiemetics?
- anticholinergics - antihistamines - cannabinoids - glucocorticoids - phenothiazides - serotonin receptor antagonists
39
how do antiemetics & antinausea drugs work
- many different MOAs | - most work by blocking one of the vomitting pathways = blocks the stimulus that induces vomiting
40
what are the 3 MOAs of anticholinergics
- bind to & block acetylcholine receptors in the inner ear labyrinth = vestibular pathway - block transmission of nauseating stimuli to CTZ - block transmission of nauseating stimuli to emetic center (bc each of these contain muscurinic/Ach receptors)
41
what is the prototype of anticholinergics
- scopolamine (buscopan)
42
what specifically is scopoalimine good for?
- motion sickness (transdermal patch)
43
what is the MOA of antihistamine drugs (H1 receptor blockers) (2)
- block action of histamine at the H1 receptor | - indirectly inhibit ACh by binding to muscurinic receptors = prevent cholinergic stimulation = prevent NV
44
what are the 4 uses of antihistamines
- motion sickness - nonproductive cough - allergy symptoms - sedation
45
what are 2 examples of antihistamines
- dimenhydrinate (gravol, dramamine) | - diphenhydramine (benadryl)
46
how do glucocorticoids work to prevent NV (2)
- anti-inflammatory --> inflammation of gut can cause NV | - can increase the antiemetic effect of serotonin blockers (ondansetron)
47
what is the use of glucocorticoids r/t NV
- treat NV associated with chemo drugs
48
what is an example of glucocorticoids for NV
- dexamethasone (dexasone)
49
what is tetrahydrocannabinoids (TCH)
- major psychoactive substance in marijuana
50
describe the use of TCH (4)
- for NV associated with chemo - for anorexia associated with weight loss in AIDS pts - increases appetite - nerve pain
51
what is a herbal product used for NV
ginger
52
describe the use of ginger (3)
for NV caused by: - chemo - motion sickness - morning sickness
53
what are the adverse effects of ginger (3)
- anorexia - NV - skin reactions
54
what are the drug interactions associated w ginger (2)
- increase absorption of oral meds | - increase bleeding risk w anticoagulants
55
what is the MOA of serotonin blockers (3)
- blocks serotonin receptors in: 1. GI tract 2. CTZ 3. emetic center
56
describe the use of serotonin blockers (2)
NV r/t 1. chemo 2. postop
57
list 2 examples of serotonin blockers
- dolasetron (anzemet) | - ondansetron (zofran)
58
what is the MOA of phenothiazines
- dopamine antagonists --> block dopamine receptors in the CTZ
59
list 2 examples of phenothiazines
- metoclopramide (maxeran) | - prochlorperazine (stemitil)
60
describe the use of phenothiazines (3)
reduce emesis r/t 1. surgery (postop) 2. cancer chemo 3. toxins
61
list adverse effects of phenothiazines (4)
- anticholinergic rxn - hypotension - sedation - extrapyramidial rxn
62
what is the main side effect r/t histamine blocking
- sedation
63
what are side effects r/t blocking Ach
- mad as a hatter (delirium) - blind as a bat (blurred vision) - dry as a bone (dry mouth and skin) - hot as a hare (fever) - red as a beet (vasodilation) - bowel & the bladder lose their tone (urinary retention & constipation) - heart runs alone (tachy)
64
what adverse effects will be seen with anticholinergics & antihistamines
- both will see s/e r/t to blocking Ach | + sedation for antihistamine
65
describe side effects for glucocorticoids
- minimal with short term use
66
describe side effects for serotonin antagonists (4)
- HA - diarrhea - dizziness - increased QT interval
67
list 2 examples of cannibinoids
- cannadibiol | - nabilone
68
list side effects of cannibinoids (3)
- subjective - tachy - hypotension
69
what is the MOA of metoclopramide (2)
prokinetic drug: - suppresses emesis by blocking dopamine receptors - increases upper GI motility by enhancing the effects of Ach
70
who can metoclopramide not be used in
- bowel obstruction - perforation - GI hemorrhage
71
list 3 common s/e of metoclorpramide
- sedation - diarrhea (due to increased motility) - tardive dyskinesia (irrevresible twitching)
72
what should be present prior to giving metoclorpramide
- BS
NURS 2514
flashcards
Decks in class (75)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions