Cyclical vomiting syndrome Cyclical vomiting syndrome - pg.5 | allnurses

Cyclical vomiting syndrome - page 5

Anybody encountered a patient with this diagnosis? I had a pt come in the other day, report of vomiting x23 during past 4 hours, severe pain 10/10 in abdomen, letter from GI doctor stating she was... Read More

  1. Visit  danagrams profile page
    0
    I've encountered this before, because I have been dating this person with cvs for the past year. I hope you're not some nurse from Houston, because I would hate to know that the people I deal with here secretly think these things about my girlfriend. I assure you, she's not a junkie, and it's pretty much her worst nightmare. Yes, the drugs feel good. But they make her sick later if she's on them too long, so no, she does not just go to the hospital pretending to be sick. In fact, it pretty much ruins her life, and she would really prefer to stay OUT of the hospital for as long as possible. The fact that no medical staff is willing to believe her conditions has made her life even worse, when she ended up tearing a hole in her esophagus and had to get surgery for it. Now she has strictures that form from this and imhas to get dilations periodically to just eat. She's also diabetic. It's really serious and very depressing at times for her, to the point where she has contemplated suicide. It would be irresponsible for any one of you to make this sort of judgment call on a person just because they ask for dilaudid by name. It's just that it works really well at stopping the vomiting. The phenergan is there to knock her out. That's the point—to stop the pain and knock her out.

    Quote from thelema13
    Anybody encountered a patient with this diagnosis? I had a pt come in the other day, report of vomiting x23 during past 4 hours, severe pain 10/10 in abdomen, letter from GI doctor stating she was diagnosed with cyclical vomiting syndrome and gastroparesis. Pt was begging for phenergen and dilaudid. Pt had previous rx for dilaudid 2mg PO, phenergen 25mg PO, and reglan 10mg PO. I gave her phenergen IV and IM, bentyl IM, protonix IV, tigan IM. Pt seemed to calm down but still begging for pain medication, asking for dilaudid by name. Became irritated when ED doc explained dilaudid may increase n/v and would not be given. (ED doc did not believe report of pain and flagged pt as drug seeker). Pt would only wretch and dry heave when I left the room or when doc was in room talking to pt. She was good enough to walk around and keep asking for pain medication. I witnessed vomiting x3 during 2.5 hour stay, watery undigested food, no bile. Im not sure what to think...........

    Any input greatly appreciated.
  2. Visit  Lxxrx profile page
    0
    I am a preceptor in a small ED and will be starting a residency in another ED right after graduation. I have been able to participate in the care of a few patients with this diagnosis and was honestly shocked by the stigma that surrounds it. My son was diagnosed with CVS at 4, he is obviously not a seeker. I know exactly what dose of medications will work to help stop an attack. Heck, he could say "ondansetron" with a sweet little lisp when getting triaged at our local children's hospital. We are lucky to have a GI that has found the right preventative medication which keeps him mostly attack free and out of the hospital. But, he also tells us that these medications are less successful the older the person gets. Gosh, I just hope that as an adult he is met with nonjudgmental compassion when he arrives at the ED.
  3. Visit  BostonFNP profile page
    0
    Quote from Lxxrx
    I am a preceptor in a small ED and will be starting a residency in another ED right after graduation. I have been able to participate in the care of a few patients with this diagnosis and was honestly shocked by the stigma that surrounds it. My son was diagnosed with CVS at 4, he is obviously not a seeker. I know exactly what dose of medications will work to help stop an attack. Heck, he could say "ondansetron" with a sweet little lisp when getting triaged at our local children's hospital. We are lucky to have a GI that has found the right preventative medication which keeps him mostly attack free and out of the hospital. But, he also tells us that these medications are less successful the older the person gets. Gosh, I just hope that as an adult he is met with nonjudgmental compassion when he arrives at the ED.
    From my professional experience, CVS in children and CVS in adults are different, remember CVS is a constellation of disorders. I have never seen an adult patient with CVS that had onset in childhood. Best of luck with your son.
  4. Visit  AZQuik profile page
    0
    Quote from Lxxrx
    I am a preceptor in a small ED and will be starting a residency in another ED right after graduation. I have been able to participate in the care of a few patients with this diagnosis and was honestly shocked by the stigma that surrounds it. My son was diagnosed with CVS at 4, he is obviously not a seeker. I know exactly what dose of medications will work to help stop an attack. Heck, he could say "ondansetron" with a sweet little lisp when getting triaged at our local children's hospital. We are lucky to have a GI that has found the right preventative medication which keeps him mostly attack free and out of the hospital. But, he also tells us that these medications are less successful the older the person gets. Gosh, I just hope that as an adult he is met with nonjudgmental compassion when he arrives at the ED.
    Not likely. As a parent of a child whose onset was 7 y/o and an ED nurse, my kid was labeled as a drug seeker and "behavioral" pt by 12.

    No such luck here with a good gi doc, and I spend most of my kids admissions arguing with "doctors". We have been threatened numerous times to have the states "child safety" called on us. My response is always the same, " if you think I'm neglecting or abusing my child, and you threaten me with reports but never make them, you should lose your license" very very frustrating.

Visit Our Sponsors
close
close