HICCUPS

DEFINITION

• Hiccup, or singultus, is defined as sudden, involuntary

contractions of one or both sides of the diaphragm and
intercostal muscles, terminated by an abrupt closure of the
glottis, producing a characteristic sound of “hic.”
 THREE CATEGORIES OF HICCUPS:

• A. Bout: Episode persisting as long as 48 hours

• B. Persistent: Episode persisting longer than 48 hours
but less than one month
• C. Intractable: Episode lasting longer than one month
Common causes in terminal illness :

• neurological disorders such stroke,brain tumors, and sepsis and metabolic

imbalance;
• phrenic nerve irritation such as tumor compression or metastases, pericarditis,
pneumonia, or pleuritis; and
• vagal nerve irritation such as esophagitis,gastric
distention,gastritis,pancreatitis,hepatitis, and myocardial infarction.
• Medications such as steroids, chemotherapy,dopamine
antagonists,megestrol,methyldopa, nicotine, opioids, and muscle relaxants may
also cause hiccups
 ASSESSMENT
• Subjective assessment- history
• physical exam - rules out other conditions
• Oral examination may reveal signs of swelling or
obstruction.
• Observation includes inspection of the patient’s general
appearance(tenderness of the temporal artery, foreign
bodies in the ear, infection of the throat, goiter in the neck,
pneumonia or pericarditis of the chest, abdominal
distention or ascites, and signs of stroke or delirium)
• Chest x-ray -pulmonary or mediastinal processes as
well as phrenic/vagal irritation
• complete blood count - may rule out infection
MANAGEMENT
NURSING INTERVENTIONS( FOCUS ON
INFORMATION SHARING AND COMFORT )

• provide patients with information on some

nonpharmacological maneuvers such as respiratory maneuvers,
nasal and pharyngeal stimulation, distraction, and peppermint
waters.
• provide education on the various classes of medications as
prescribed as options
• Offering support to the patient