Emesis

Definition

Emesis is the forceful expulsion of stomach contents through the mouth. It is a protective reflex but can cause significant complications with persistent vomiting.

Key Assessment Parameters

• Color: clear, bilious (green/yellow), bloody (hematemesis), coffee-ground (digested blood from upper GI bleed), fecal (bowel obstruction)
• Amount and frequency
• Relationship to meals or medications
• Associated symptoms: abdominal pain, fever, headache

Complications

Dehydration, metabolic alkalosis (loss of hydrogen ions), hypokalemia, aspiration pneumonia, Mallory-Weiss tear (esophageal laceration), Boerhaave syndrome (esophageal rupture; surgical emergency).

Nursing Interventions

Position side-lying or high-Fowler's to prevent aspiration, administer anti-emetics (ondansetron, metoclopramide), provide oral rehydration or IV fluids, maintain I&O, offer small sips of clear liquids when tolerated, progress diet. Monitor electrolytes and correct imbalances.

NCLEX Relevance

Coffee-ground emesis = upper GI bleed. Persistent vomiting → metabolic alkalosis and hypokalemia.