Symptom: Nausea

Initial Grading Reminder

CTCAE grading of nausea:

Grade 1 (Mild): Loss of appetite without alteration in eating habits
Grade 2 (Moderate): Oral intake decreased without significant weight loss, dehydration, or malnutrition
Grade 3 (Severe): Inadequate oral caloric or fluid intake; tube feeding, TPN, or hospitalization indicated

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly? Does it come or go or are you nauseated constantly? Have you had any issues with nausea in the past? What are you taking for the nausea? Are you using marijuana?

Grade the symptom

Ask the patient:

How nauseated are you? Are you throwing up? Does it come and go, or are you nauseated constantly? Are you able to eat? How much fluid are you drinking per day? Have you lost weight?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Do you have a headache, vision changes, fever, and vomiting? Are you feeling faint? Do you have any blood in your stool or severe stomach pain? Do you have any swelling of your ankles or your abdomen (belly)?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?