thanks.. the patients, seek medical attention because she felt nauseated and felt like being to vomit, but, as when we assessed her using the 13 areas, we didn'find anything wrong. she said she was tired that time and skip dinner and just took her medication for HPN which we thought taking medications with empty stomach causes irritation in her gastric lining that make her feel nauseated and was like to vomit..we also noted that her fingernails are dirty and might be one of the causes of having acute gastroenteritis. we made nursing care plan for hygiene. what makes the worst most is when the patient does'nt want to tell the truth. anyways, thanks for your response, and now i know h\what to do the next time.. thanks a lot and looking forward for you advise when i need..