Any ideas for unrelieved N/V

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I have been doing Hospice care for about 5 years now. I recently had a patient with CA of the gallbladder and had uncontrolled n/v. We tried topical compounds, PO meds (Phenegran, reglan and finally switched to Zofran) with still very little relief from the vomting. We also tried Scaplomine transderm scope patches. Any body with any other ideas??? She refuses anything rectally and refuses any injections or IV or line placement....

For anyone new getting started in Hospice it has been one of the toughest and yet MOST REWARDING decisions I ever made.

Specializes in LTC, Hospice, Case Management.

I was going to say Marinol too. We've used in the past, but not sure that it is legal in all states? Anyone else know?

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We used to find that the scopolamine patches worked great but now we use atropine gtts for teminal congestion. I had a patient that was obstucted and MD Anderson had given him all the big guns in IV's and I tried Scope patches and some ativan sublingual and it worked great.....of course it didn't completely take care of it as he was obstructed but he didn't vomit quiet as often. He was very relieved to have a few minutes of rest in between. Maybe the atropine gtts would dry the pt up so he didn't have much to get rid of. Good luck.....let us know what works!

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Specializes in NICU.

This is an interesting thread to me as my brother-in-law has prostate CA, and has n/v. The doc says he's not ready for Hospice care, and yet he has to have frequent blood transfusions, for chronic blood loss. He has problems with most pain meds, which make the n/v worse. He can't keep much down, and has lost a lot of weight. He becomes dehydrated, and has to go in for IV rehydration.

I think I'll suggest the wrist bands, they might help!

Unfortunately, they live 200 miles away from us, and we don't get to visit much. I can't imagine that he's going to live very long. He has had this diagnosis for 8 years.

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Flat gingerale works for some people. Take a half a glass of gingerale and stir in about a teaspoon of sugar and watch the fizz go out of - and then drink.

But, the most effective remedy I have seen has been the wrist bands for nausea.

Hope this helps,

Holistic

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I was going to say Marinol too. We've used in the past, but not sure that it is legal in all states? Anyone else know?

Yes, it is legal in all states. I don't think it will do much for an obstructed pt, though.

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wrist bands? what are they?

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wrist bands? what are they?

Check it out here:

http://www.sea-band.com/seaband.htm

I tried accupressure on that point myself last summer when I was at the fair and riding the pirate ship. I really began to feel queasy so I used accupressure and focused on my breathing and then it eased up.

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