Management of Nausea Following IUD Removal and Insertion

Immediate Recognition and Management

Nausea is a key warning sign of vasovagal reaction that clinical support staff should be trained to recognize, along with pale skin, sweating, dilated pupils, and dizziness 1, 2
The American College of Obstetricians and Gynecologists recommends positioning the patient supine immediately to prevent syncope and maintain cerebral perfusion 1
Apply cold, wet towels to the forehead for comfort, as recommended by the American Journal of Obstetrics and Gynecology 3, 4
Offer beverages and snacks once the patient is stable, according to the American Journal of Obstetrics and Gynecology 4
Keep the patient recumbent until symptoms fully resolve, as suggested by the American College of Obstetricians and Gynecologists 1, 2

Peppermint essential oil aromatherapy may reduce post-procedural nausea, based on evidence from other surgical procedures 4
Apply acupressure to the Large Intestine-4 (LI4) point on the dorsum of the hand or Spleen-6 (SP6) point above the medial malleolus, as recommended by the American Journal of Obstetrics and Gynecology 3, 4

Administer naproxen 440-550 mg every 12 hours OR ibuprofen 600-800 mg every 6-8 hours with food for the first 24 hours post-procedure, as suggested by the American College of Obstetricians and Gynecologists 3, 4
NSAIDs address cramping pain that may contribute to nausea and overall discomfort, according to the American Journal of Obstetrics and Gynecology 3, 4

Set realistic expectations about common side effects including transient nausea during or immediately after the procedure, as recommended by the American College of Obstetricians and Gynecologists 1, 2
Use trauma-informed care principles and therapeutic language to reduce anxiety, which can exacerbate vasovagal responses, according to the American Journal of Obstetrics and Gynecology 1, 2
Consider anxiolytics for patients with significant pre-procedural anxiety, though this requires arranged transportation home, as suggested by the American College of Obstetricians and Gynecologists 3, 4