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The Management of Nausea at the End of Life

Moorthy, Gayathri S., PhD, BSc, RN; Letizia, MariJo, PhD, MSN, BSN

Journal of Hospice & Palliative Nursing: October 2018 - Volume 20 - Issue 5 - p 442–449
doi: 10.1097/NJH.0000000000000453
Symptom Management Series

The evaluation and management of nausea in patients near the end of life can be more challenging than that of nausea in patients undergoing antineoplastic therapies. Unlike in the oncology setting in which nausea is primarily managed using antiemetic regimens that have been developed with the neuropharmacology and emetogenic potentials of chemotherapy agents in mind, many patients receiving end-of-life care have nausea of multifactorial etiology. Patients also may be older with reduced physiologic ability to metabolize and clear drugs. Therefore, typical antiemetics in regimens initially selected for oncology patients may be ineffective. In this article, the prevalence, manifestation, and pathophysiology of nausea experienced by patients near and at the end of life will be reviewed, with a focus on pharmacological and nonpharmacological interventions that have been found to effectively manage this symptom in this patient population.

Gayathri S. Moorthy, PhD, BSc, RN, is staff nurse, DuPage Medical Group, Lisle, IL.

MariJo Letizia, PhD, MSN, BSN, is professor, Loyola University Chicago, IL.

Address correspondence to MariJo Letizia, PhD, MSN, BSN, School of Nursing, Loyola University Chicago, 2160 S First Ave, Maywood, IL 60153 (

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.