Rosh Emergency Medicine Practice Test

In the case of a patient with persistent nausea and vomiting post-surgery, what is the earliest intervention to alleviate symptoms?

1. Administer antihistamines for nausea control

2. Provide intravenous fluids for hydration

3. Introduce a clear liquid diet gradually

4. Order antiemetic medications such as ondansetron

The correct answer is: Order antiemetic medications such as ondansetron

In addressing persistent nausea and vomiting following surgery, administering antiemetic medications like ondansetron serves as the earliest and most direct intervention to alleviate these symptoms. Post-operative nausea and vomiting (PONV) can significantly disrupt a patient's recovery process and is quite common due to various factors such as anesthesia, surgical manipulation, and the overall stress of the surgical procedure. Antiemetics specifically target the pathways in the brain that trigger nausea and vomiting, providing rapid relief. Ondansetron is a selective serotonin 5-HT3 receptor antagonist that has been well-studied and proven effective in preventing and treating nausea associated with chemotherapy and surgery. By addressing the nausea directly with pharmacological intervention, you improve the patient’s comfort and can facilitate their recovery and ability to tolerate other interventions or oral intake. While intravenous fluids are important for hydration, especially if the patient is unable to keep down oral fluids, this approach does not target the underlying cause of nausea. Similarly, a gradual introduction of a clear liquid diet will only be effective once the nausea is managed, as it might exacerbate symptoms if attempted prematurely. Antihistamines can also be helpful for nausea but are typically used in different contexts, such as motion sickness or labyrinthine disorders. Therefore, the focus