vomit - fluids or elimination

[lilbitloa]

doing my first care plan. in my senerio, my patient has hematemesis. i have to place it in a in one or the other.

[LMRN10]

I would think Vomit would be elimination. I would think Fluids would be what you take in...

[lilbitloa]

i just finished writing it and i did put it under elimination. thanks for the reassurance.

[Daytonite, BSN, RN]

i disagree here, guys. if you go look to gordon's functional needs you will find that her pattern of elimination describes it as "the patterns of excretory function (bowel, bladder, and skin)". vomiting is not an excretory function. it has to do with food and fluid. taber's cyclopedic medical dictionary defines elimination as excretion of waste products by the skin, kidneys, lungs, and intestines. emesis coming from the stomach is not a waste product. ask yourself why a patient vomits. it is not to rid the body of waste. it is sometimes because something has gone wrong with peristalsis. the stimulus to vomit comes from the brain.

if you were going to care plan anything to do with vomiting, it is going to go under a nutrition or fluid deficit diagnosis, not one of the elimination ones. there is no nursing diagnosis of "vomiting" and the nursing diagnosis of nausea is classified under nutritional-metabolic needs in gordon's system.

sorry, but i think you need to re-do your care plan.

[RNMeg]

I was about to post a response about vomiting resulting in fluid loss (and possibly dehydration) rather than elimination, but Daytonite said it better than I ever could

I definitely agree, rethink that part of your careplan :redpinkhe

[lilbitloa]

thank you for your expert opinion. this being my first one, i didn't know how to go about it.

[NPs4health]

Yup I agree that fluid volume deficit and maybe even electrolyte imbalance can be a result of vomiting but I can't see how fluids/elimination would fit in here. Maybe you're trying to count it as the patient's output for the shift? That would make a bit more sense but still wouldn't be a nursing diagnosis if that's what you're looking for.

[lilbitloa]

hematemesis had to be placed in an assessment catagory (ie. fluids/nutrition or elimination) i went with fluid volume deficit under the catagory fluids.

thanks for all your help ladies. have a great holiday.

it's sunny and hot here in florida.

christine

[LMRN10]

Yes, I would agree that it would be fluid volume deficit/dehydration as well...

The only reason I said elimination was because she said it had to be one or the other and I was looking at it as fluid intake, not thinking of fluid volume deficit. So yes, I agree with that for sure!!

Sorry!

[stormymemphis]

Vomit is not considered elimination. It is not a natural process of riding the body of waste. If vomiting is occuring, something is wrong and you are losing FLUIDS!