Vomiting evaluation

Before the first dose of an amebicide is given, the nurse records the patient s vital signs and weight. The nurse evaluates the general physical status of the patient and looks for evidence of dehydration, especially if severe vomiting and diarrhea have occurred. 

Treatment of distal intestinal obstruction syndrome (DIOS) consists of oral or nasogastric administration of polyethylene glycol electrolyte (PEG) solutions. Enemas may also be used to facilitate stool clearance. IV fluids are often required to correct dehydration due to vomiting or decreased oral intake. Re-evaluation of enzyme compliance and dosing is essential to prevent further episodes. Patients with recurrent symptoms may require daily PEG administration (Miralax ).5 Severe presentations of DIOS or initial meconium ileus may require surgical resection. 

Outline a monitoring plan to evaluate the treatment outcomes for nausea and vomiting. 

TMP-SMX Nausea/vomiting Myelosuppression monitor CBC Hepatic abnormalities monitor LFTs Rash including severe reactions such as Stevens-Johnson syndrome Inhibitor of CYP2C9 evaluate for potential drug-drug interactions such as warfarin... 

Overall survival is affected by the success of the initial surgery to debulk the tumor to less than 1 cm of disease and response to first-line chemotherapy. The CA-125 level should be monitored with each cycle, and at least a 50% reduction in CA-125 after four cycles of taxane/platinum chemotherapy is related to an improved prognosis. Patients who achieve a complete response should have follow-up examinations every 3 months, including CA-125 determination, physical examination, pelvic examination, and appropriate diagnostic scans (e.g., CT scan, MRI, or PET scan) and should be evaluated for the detection of disease. Evaluate patients for resolution of any residual chemotherapy-related side effects, including neuropathies, nephrotoxicity, ototoxicity, myelosuppression, and nausea/vomiting. 

An evaluation of the rifaximin tolerability profile observed in almost 1,000 patients from 30 clinical trials was unable to identify a definite pattern of intolerance [33]. Very few adverse events have been reported during short-tem treatment with the drug, the most frequently reported being gastrointestinal in nature (e.g. flatulence, nausea, abdominal pain and vomiting). It is worthwhile to emphasize that the detection of GI adverse reactions could have been difficult in rifaximin trials since the symptoms of the underlying diseases were often similar to the GI complaints observed after drug treatment. 

Patients presenting with a rash or skin lesion should be evaluated for potential anaphylaxis or angioedema (e.g., symptoms of difficulty in breathing, fever, nausea, vomiting). 

In the headache evaluation, diagnostic alarms should be identified. These include acute onset of the first or worst headache ever, accelerating pattern of headache following subacute onset, onset of headache after age 50 years, headache associated with systemic illness (e.g., fever, nausea, vomiting, stiff neck, and rash), headache with focal neurologic symptoms or papilledema, and new-onset headache in a patient with cancer or human immunodeficiency virus infection. 

Bevacizumab is also associated with GI perforation. This rare, but potentially fatal, complication necessitates prompt evaluation of abdominal pain associated with vomiting or constipation. 

Patients should be evaluated for anticipated side effects such as loose stools or diarrhea, nausea or vomiting, mouth sores, fatigue, and fever. 

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