• History ‒ a separate history for both nausea and vomiting:
    • triggers, volume, pattern
    • exacerbating and relieving factors, including individual and combinations of drugs tried and routes used
    • bowel habit
    • medication – consider drugs that may:
      • contribute to the nausea and vomiting
      • cause harm
      • not take effect due to the nausea and vomiting
    • exclude regurgitation as this will require a different approach. If suspected consider seeking advice
    • check for other concurrent symptoms. 

 

  • Examination:
    • general review for signs of dehydration, sepsis and drug toxicity
    • central nervous system
    • abdomen (for example organomegaly, bowel sounds, succussion splash)
    • check temperature, pulse and respiration

 

  • Blood investigations where appropriate may include:
    • urea and electrolytes
    • liver function tests
    • calcium
    • blood glucose.

 

  • Consider excluding urinary infection.