Paper
Saturday, July 24, 2004
Self-Care Activities for Post-discharge Nausea and Vomiting Following Ambulatory Surgery
Susan J. Fetzer, RN, PhD, Department of Nursing, Department of Nursing, University of New Hampshire, Durham, NH, USA
| Learning Objective #1: List three common self-care activities ambulatory surgery patients use post-discharge to manage nausea and vomiting |
| Learning Objective #2: State the importance of helping the patient develop a post-discharge plan to manage nausea, vomiting, and pain following ambulatory surgery |
Objective: The purpose of this study was to describe self-care activities that ambulatory surgical(AS) patients use to manage post operative nausea and vomiting (PDNV) during the first 24 hours of discharge. Design: A descriptive prospective study. Population, Sample, Setting, Years: A purposeful sample of 190 adult AS patients from four facilities in the northeastern US. Patients were included if they were discharged within 4 hours of surgery, had not experienced nasuea anv vomiting prior to discharge, but did experience PDNV within the 24 hours of discharge. Data were collected from November 2001 to May, 2002. Concepts: Post operative nausea and vomiting, self-care activities. Methods: After IRB approval, adult AS patients were approached during the preoperative period. Data was collected by telephone during the standard 24 hour post discharge nursing assessment. Questions on self-care activities were developed by the researcher and pilot tested on 20 ASC patients for clarity and ease of understanding. Findings: The most frequent explanation provided for PDNV was pain medication, followed by anesthesia and movement. The most frequently reported self-care activity was to stop taking pain medication. Additional self-care activities included drinking or eating. Only seven subjects contacted their physician. Self-care activities were effective for over 70% of subjects. Conclusions: While pain is a known risk factor for PDNV, unrelieved post operative pain can also lead to more serious complications such as post operative atelectasis and poor wound healing. While stopping pain medication may be an effective in relieving PDNV, subjects in this study chose a self-care activity that could be detrimental to their recovery. Implications: Nurses must provide information to patients prior to discharge on self-care activities that can best manage PDNV without increasing risk of post operative pain. Further study is needed to determine an appropriate pain management strategy in the presence of PONV.
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Sigma Theta Tau International
July 22-24, 2004