Why Do I Feel Nauseous And Dizzy: Comprehensive Guide

Why Do I Feel Nauseous And Dizzy? At WHY.EDU.VN, we understand how unsettling these symptoms can be, often indicating underlying health issues or lifestyle factors. We aim to provide a comprehensive exploration of the potential causes of nausea and dizziness, offering insights and practical guidance to help you understand and address these concerns, improving your overall well-being. This includes delving into possible inner ear problems, low blood sugar, and dehydration.

1. Understanding Nausea and Dizziness

Nausea is the sensation of unease and discomfort in the stomach, often accompanied by the urge to vomit. Dizziness, on the other hand, involves a feeling of being unsteady, lightheaded, or off-balance. Both symptoms can occur independently or together, significantly affecting your daily life.

1.1. What is Nausea?

Nausea is more than just a feeling of discomfort; it’s a complex physiological response. It can be triggered by various factors, ranging from motion sickness to serious medical conditions. Understanding the nuances of nausea can help in identifying its cause and implementing appropriate solutions.

1.2. What is Dizziness?

Dizziness encompasses a range of sensations, from a slight lightheadedness to a severe spinning sensation known as vertigo. It can be caused by problems in the inner ear, brain, or circulatory system. Accurately describing your dizziness to a healthcare professional is crucial for a proper diagnosis.

1.3. The Connection Between Nausea and Dizziness

Nausea and dizziness often occur together because they share common neurological pathways and physiological triggers. For example, inner ear disorders can disrupt balance and cause both nausea and dizziness. Similarly, conditions affecting blood flow to the brain can lead to both symptoms.

Alt: The complex interplay between nausea and dizziness, highlighting shared neurological pathways and physiological triggers.

2. Common Causes of Nausea and Dizziness

Several factors can trigger nausea and dizziness, ranging from mild and temporary conditions to more serious underlying health issues. Identifying the root cause is essential for effective management and treatment.

2.1. Inner Ear Problems

The inner ear plays a crucial role in maintaining balance. Conditions affecting the inner ear can lead to vertigo, dizziness, and nausea.

2.1.1. Benign Paroxysmal Positional Vertigo (BPPV)

BPPV is one of the most common causes of vertigo. It occurs when small calcium crystals in the inner ear become dislodged and interfere with the balance signals sent to the brain.

Symptoms: Brief episodes of vertigo triggered by specific head movements.
Diagnosis: Dix-Hallpike maneuver performed by a healthcare professional.
Treatment: Epley maneuver, a series of head movements to reposition the calcium crystals.

2.1.2. Meniere’s Disease

Meniere’s disease is a chronic inner ear disorder characterized by episodes of vertigo, tinnitus (ringing in the ears), hearing loss, and a feeling of fullness in the ear.

Symptoms: Recurring episodes of vertigo, fluctuating hearing loss, tinnitus, and aural fullness.
Diagnosis: Hearing tests, balance tests, and MRI scans to rule out other conditions.
Treatment: Medications to manage symptoms (e.g., antiemetics, antihistamines), lifestyle changes (e.g., low-sodium diet), and in severe cases, surgery.

2.1.3. Labyrinthitis and Vestibular Neuritis

Labyrinthitis and vestibular neuritis are inner ear infections that cause inflammation of the inner ear nerves responsible for balance and hearing.

Symptoms: Sudden onset of vertigo, nausea, vomiting, and imbalance. Labyrinthitis may also cause hearing loss.
Diagnosis: Physical examination, hearing tests, and balance tests.
Treatment: Antibiotics for bacterial infections, corticosteroids to reduce inflammation, and vestibular rehabilitation therapy.

2.2. Dehydration

Dehydration occurs when the body loses more fluids than it takes in, leading to a decrease in blood volume and potential electrolyte imbalances.

Symptoms: Dizziness, lightheadedness, nausea, headache, fatigue, and dark urine.
Diagnosis: Physical examination, review of fluid intake and output, and blood tests to check electrolyte levels.
Treatment: Oral rehydration with water and electrolyte-rich beverages, and in severe cases, intravenous fluids.

2.3. Low Blood Sugar (Hypoglycemia)

Low blood sugar, or hypoglycemia, occurs when glucose levels in the blood drop too low, depriving the brain of its primary energy source.

Symptoms: Dizziness, lightheadedness, nausea, sweating, shakiness, confusion, and irritability.
Diagnosis: Blood glucose test to measure current blood sugar levels.
Treatment: Consuming fast-acting carbohydrates (e.g., glucose tablets, fruit juice), followed by a balanced meal or snack.

2.4. Migraines

Migraines are severe headaches that can cause a variety of symptoms, including nausea, dizziness, and sensitivity to light and sound.

Symptoms: Intense throbbing headache, nausea, vomiting, dizziness, visual disturbances (aura), and sensitivity to light and sound.
Diagnosis: Detailed medical history, neurological examination, and sometimes brain imaging to rule out other conditions.
Treatment: Pain relievers (e.g., ibuprofen, acetaminophen), triptans (for migraine-specific relief), and preventive medications (e.g., beta-blockers, antidepressants).

2.5. Anxiety and Panic Attacks

Anxiety and panic attacks can trigger a range of physical symptoms, including nausea and dizziness, due to the body’s stress response.

Symptoms: Dizziness, lightheadedness, nausea, rapid heart rate, shortness of breath, sweating, trembling, and a sense of impending doom.
Diagnosis: Psychological evaluation to assess anxiety levels and identify triggers.
Treatment: Cognitive-behavioral therapy (CBT), relaxation techniques, and medications (e.g., antidepressants, anti-anxiety drugs).

2.6. Medications

Certain medications can cause nausea and dizziness as side effects. It’s essential to review your medication list with your healthcare provider.

Common Culprits: Antidepressants, antibiotics, blood pressure medications, pain relievers, and chemotherapy drugs.
Management: Discuss alternative medications with your doctor, adjust dosages if possible, and manage symptoms with antiemetics or other supportive treatments.

2.7. Motion Sickness

Motion sickness occurs when there is a conflict between what the eyes see and what the inner ears sense, often experienced during travel.

Symptoms: Nausea, vomiting, dizziness, headache, and cold sweats.
Prevention: Medications (e.g., dimenhydrinate, meclizine), ginger supplements, acupressure bands, and focusing on a fixed point in the distance.

2.8. Food Poisoning

Food poisoning is caused by consuming contaminated food containing bacteria, viruses, or parasites.

Symptoms: Nausea, vomiting, diarrhea, abdominal cramps, fever, and dizziness.
Diagnosis: Stool sample analysis to identify the causative organism.
Treatment: Rehydration with oral or intravenous fluids, rest, and in severe cases, antibiotics.

2.9. Heart Problems

Heart conditions that affect blood flow to the brain can cause dizziness and lightheadedness.

Examples: Arrhythmias, heart failure, and low blood pressure.
Symptoms: Dizziness, lightheadedness, chest pain, shortness of breath, and palpitations.
Diagnosis: Electrocardiogram (ECG), echocardiogram, and other cardiac tests.
Treatment: Medications, lifestyle changes, and in some cases, surgery or medical devices (e.g., pacemaker).

2.10. Neurological Conditions

Certain neurological conditions can affect balance and coordination, leading to dizziness and nausea.

Examples: Multiple sclerosis, Parkinson’s disease, and stroke.
Symptoms: Dizziness, imbalance, coordination problems, muscle weakness, and sensory disturbances.
Diagnosis: Neurological examination, MRI scans, and other diagnostic tests.
Treatment: Medications, physical therapy, and occupational therapy to manage symptoms and improve quality of life.

Alt: Detailed anatomy of the inner ear, highlighting its critical role in maintaining balance and spatial orientation.

3. Rare Causes of Nausea and Dizziness

While less common, some rare conditions can also cause nausea and dizziness. These conditions often require specialized medical evaluation and treatment.

3.1. Brain Tumors

Brain tumors can cause nausea and dizziness if they compress or disrupt the function of brain regions involved in balance and coordination.

Symptoms: Persistent headaches, nausea, vomiting, dizziness, vision changes, seizures, and cognitive impairment.
Diagnosis: MRI or CT scans of the brain, neurological examination, and biopsy for confirmation.
Treatment: Surgery, radiation therapy, chemotherapy, or a combination of these modalities.

3.2. Multiple Sclerosis (MS)

MS is an autoimmune disease that affects the central nervous system, causing a range of symptoms, including dizziness and nausea.

Symptoms: Fatigue, numbness, tingling, muscle weakness, vision problems, dizziness, and cognitive difficulties.
Diagnosis: MRI scans of the brain and spinal cord, neurological examination, and cerebrospinal fluid analysis.
Treatment: Medications to modify the disease course (e.g., interferon, glatiramer acetate), symptom management (e.g., corticosteroids, muscle relaxants), and rehabilitation therapies.

3.3. Addison’s Disease

Addison’s disease, or adrenal insufficiency, occurs when the adrenal glands do not produce enough cortisol and aldosterone.

Symptoms: Fatigue, muscle weakness, weight loss, nausea, vomiting, dizziness, low blood pressure, and skin darkening.
Diagnosis: Blood tests to measure cortisol and ACTH levels, ACTH stimulation test, and imaging studies of the adrenal glands.
Treatment: Hormone replacement therapy with corticosteroids (e.g., hydrocortisone, prednisone) and mineralocorticoids (e.g., fludrocortisone).

3.4. Carbon Monoxide Poisoning

Exposure to carbon monoxide, a colorless and odorless gas, can lead to nausea and dizziness, along with other serious symptoms.

Symptoms: Headache, nausea, vomiting, dizziness, weakness, confusion, and loss of consciousness.
Diagnosis: Blood test to measure carboxyhemoglobin levels.
Treatment: Administration of 100% oxygen, monitoring of vital signs, and supportive care.

3.5. Chiari Malformation

Chiari malformation is a structural defect in which brain tissue extends into the spinal canal, potentially causing dizziness and balance problems.

Symptoms: Headache, neck pain, dizziness, balance problems, muscle weakness, and vision disturbances.
Diagnosis: MRI scan of the brain and spinal cord.
Treatment: Surgery to relieve pressure on the brain and spinal cord.

4. When to Seek Medical Attention

While many cases of nausea and dizziness are temporary and resolve on their own, certain symptoms warrant immediate medical attention.

Severe Symptoms: Persistent vomiting, high fever, severe headache, chest pain, difficulty breathing, and loss of consciousness.
Neurological Symptoms: Sudden weakness, numbness, difficulty speaking, vision changes, and seizures.
Head Trauma: Dizziness and nausea following a head injury, even if mild.
Chronic Symptoms: Frequent or persistent episodes of nausea and dizziness that interfere with daily life.

If you experience any of these symptoms, seek prompt medical evaluation at 101 Curiosity Lane, Answer Town, CA 90210, United States, or contact us via Whatsapp at +1 (213) 555-0101. You can also find reliable information and answers to your health questions at WHY.EDU.VN.

5. Diagnostic Tests for Nausea and Dizziness

Diagnosing the cause of nausea and dizziness often involves a combination of medical history, physical examination, and specialized tests.

5.1. Physical Examination

A thorough physical examination can provide valuable clues about the underlying cause of your symptoms.

Neurological Exam: Assessment of balance, coordination, reflexes, and sensory function.
Ear Exam: Examination of the ear canal and eardrum to identify signs of infection or inflammation.
Cardiovascular Exam: Measurement of blood pressure and heart rate, and auscultation of heart sounds.

5.2. Blood Tests

Blood tests can help identify underlying medical conditions that may be contributing to nausea and dizziness.

Complete Blood Count (CBC): To check for infection or anemia.
Electrolyte Panel: To assess electrolyte balance.
Blood Glucose Test: To measure blood sugar levels.
Thyroid Function Tests: To evaluate thyroid hormone levels.
Kidney and Liver Function Tests: To assess organ function.

5.3. Imaging Studies

Imaging studies can provide detailed images of the brain, inner ear, and other structures, helping to identify structural abnormalities or other potential causes of nausea and dizziness.

MRI (Magnetic Resonance Imaging): Provides detailed images of the brain and inner ear.
CT Scan (Computed Tomography): Can detect brain tumors, strokes, and other abnormalities.
Electronystagmography (ENG): Measures eye movements to assess inner ear function.
Videonystagmography (VNG): A more advanced version of ENG, providing a more detailed assessment of inner ear function.

5.4. Balance Tests

Balance tests can help assess the function of the inner ear and balance system.

Romberg Test: Assesses the ability to maintain balance while standing with eyes closed.
Dix-Hallpike Maneuver: Used to diagnose BPPV by observing eye movements in response to specific head movements.
Caloric Testing: Stimulates the inner ear with warm and cold water to assess its response.

5.5. Hearing Tests (Audiometry)

Hearing tests can help identify hearing loss or other auditory abnormalities that may be contributing to dizziness.

Pure-Tone Audiometry: Measures hearing sensitivity at different frequencies.
Tympanometry: Assesses the function of the middle ear.

6. Treatment Options for Nausea and Dizziness

Treatment for nausea and dizziness depends on the underlying cause. Here are some common treatment options:

6.1. Medications

Various medications can help alleviate nausea and dizziness.

Antiemetics: Medications to reduce nausea and vomiting (e.g., ondansetron, promethazine).
Antihistamines: Medications to relieve dizziness and motion sickness (e.g., meclizine, dimenhydrinate).
Benzodiazepines: Medications to reduce anxiety and dizziness (e.g., diazepam, lorazepam).
Diuretics: Medications to reduce fluid retention in Meniere’s disease (e.g., hydrochlorothiazide).

6.2. Lifestyle Changes

Making certain lifestyle changes can help manage and prevent nausea and dizziness.

Hydration: Drink plenty of fluids to prevent dehydration.
Diet: Eat small, frequent meals to maintain stable blood sugar levels.
Avoid Triggers: Identify and avoid triggers that exacerbate your symptoms (e.g., strong odors, certain foods).
Rest: Get plenty of rest to allow your body to recover.
Stress Management: Practice relaxation techniques to reduce stress and anxiety.

6.3. Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy that helps improve balance and reduce dizziness.

Exercises: Specific exercises to retrain the brain to compensate for inner ear dysfunction.
Techniques: Gaze stabilization exercises, balance training, and habituation exercises.

6.4. Home Remedies

Several home remedies can help alleviate nausea and dizziness.

Ginger: Ginger has anti-nausea properties and can be consumed in various forms (e.g., ginger tea, ginger candy).
Peppermint: Peppermint can help relieve nausea and soothe the stomach.
Acupressure: Applying pressure to specific acupressure points can help reduce nausea.
Deep Breathing: Practicing deep breathing exercises can help calm the nervous system and reduce dizziness.

6.5. Surgical Options

In some cases, surgery may be necessary to treat the underlying cause of nausea and dizziness.

Endolymphatic Sac Decompression: A surgical procedure to reduce fluid pressure in the inner ear for Meniere’s disease.
Vestibular Nerve Section: A surgical procedure to cut the vestibular nerve, reducing vertigo symptoms.
Labyrinthectomy: A surgical procedure to remove the inner ear, eliminating vertigo symptoms but also causing hearing loss.

7. Preventing Nausea and Dizziness

Preventing nausea and dizziness involves identifying and managing risk factors, as well as adopting healthy lifestyle habits.

7.1. Stay Hydrated

Dehydration is a common cause of dizziness and nausea. Drink plenty of water throughout the day, especially during physical activity or in hot weather.

7.2. Manage Blood Sugar Levels

Maintain stable blood sugar levels by eating regular meals and snacks, and avoiding sugary foods and drinks.

7.3. Avoid Triggers

Identify and avoid triggers that exacerbate your symptoms, such as strong odors, certain foods, or stressful situations.

7.4. Get Enough Sleep

Lack of sleep can worsen dizziness and nausea. Aim for 7-8 hours of quality sleep each night.

7.5. Practice Stress Management

Chronic stress can contribute to nausea and dizziness. Practice relaxation techniques such as deep breathing, meditation, or yoga.

7.6. Limit Alcohol and Caffeine

Alcohol and caffeine can dehydrate the body and exacerbate dizziness. Limit your intake of these substances.

7.7. Use Motion Sickness Remedies

If you are prone to motion sickness, use preventative measures such as medications, acupressure bands, or ginger supplements before traveling.

8. The Role of Diet in Managing Nausea and Dizziness

Diet plays a significant role in managing nausea and dizziness. Certain foods and eating habits can help alleviate symptoms, while others can exacerbate them.

8.1. Foods to Eat

Bland Foods: Easily digestible foods such as toast, crackers, and plain rice can help settle the stomach.
Ginger: Ginger has anti-nausea properties and can be consumed in various forms (e.g., ginger tea, ginger ale).
Peppermint: Peppermint can help relieve nausea and soothe the stomach.
Broth: Clear broths can help hydrate the body and provide essential nutrients.
Bananas: Bananas are a good source of potassium and can help replenish electrolytes.

8.2. Foods to Avoid

Fatty Foods: High-fat foods can slow down digestion and worsen nausea.
Spicy Foods: Spicy foods can irritate the stomach and exacerbate nausea.
Acidic Foods: Acidic foods such as citrus fruits and tomatoes can irritate the stomach.
Caffeine: Caffeine can dehydrate the body and worsen dizziness.
Alcohol: Alcohol can dehydrate the body and irritate the stomach.

8.3. Eating Habits

Eat Small, Frequent Meals: Eating small, frequent meals can help maintain stable blood sugar levels and prevent nausea.
Eat Slowly: Eating too quickly can overload the digestive system and worsen nausea.
Avoid Lying Down After Eating: Lying down after eating can slow down digestion and increase the risk of nausea.
Stay Hydrated: Drink plenty of fluids throughout the day to prevent dehydration.

9. Understanding Vertigo vs. Dizziness

Vertigo and dizziness are often used interchangeably, but they refer to different sensations. Understanding the distinction between the two can help in identifying the underlying cause and seeking appropriate treatment.

9.1. Vertigo

Vertigo is the sensation of spinning or whirling, either of yourself or your surroundings. It is often caused by problems in the inner ear or brain.

Symptoms: Spinning sensation, imbalance, nausea, vomiting, and difficulty walking.
Common Causes: BPPV, Meniere’s disease, and vestibular neuritis.

9.2. Dizziness

Dizziness is a more general term that refers to a feeling of being unsteady, lightheaded, or off-balance. It can be caused by a variety of factors, including dehydration, low blood sugar, and anxiety.

Symptoms: Lightheadedness, unsteadiness, blurred vision, and confusion.
Common Causes: Dehydration, low blood sugar, anxiety, and medications.

9.3. Differentiating Between Vertigo and Dizziness

Sensation: Vertigo involves a spinning sensation, while dizziness involves a more general feeling of unsteadiness.
Cause: Vertigo is often caused by inner ear or brain problems, while dizziness can be caused by a variety of factors.
Severity: Vertigo is often more severe and debilitating than dizziness.

Alt: Visual representation distinguishing vertigo from dizziness, emphasizing the spinning sensation in vertigo versus the general unsteadiness in dizziness.

10. Living with Chronic Nausea and Dizziness

Living with chronic nausea and dizziness can be challenging, but there are strategies to manage symptoms and improve quality of life.

10.1. Create a Management Plan

Work with your healthcare provider to develop a comprehensive management plan that includes medications, lifestyle changes, and home remedies.

10.2. Identify and Avoid Triggers

Keep a journal to track your symptoms and identify potential triggers, such as certain foods, odors, or activities.

10.3. Practice Self-Care

Prioritize self-care activities that help reduce stress and promote relaxation, such as deep breathing, meditation, or yoga.

10.4. Seek Support

Connect with support groups or online communities to share your experiences and learn from others who are living with chronic nausea and dizziness.

10.5. Stay Active

Engage in regular physical activity to improve balance and coordination. Start with gentle exercises and gradually increase intensity as tolerated.

10.6. Modify Your Environment

Make modifications to your home and workplace to reduce the risk of falls and injuries. Install grab bars in the bathroom, use non-slip mats, and ensure adequate lighting.

11. Nausea and Dizziness in Children

Nausea and dizziness can occur in children for a variety of reasons, ranging from common childhood illnesses to more serious medical conditions.

11.1. Common Causes

Viral Infections: Viral infections such as gastroenteritis can cause nausea, vomiting, and dizziness.
Motion Sickness: Children are particularly susceptible to motion sickness, especially during car rides or other forms of travel.
Dehydration: Dehydration can occur quickly in children, especially during illness or physical activity.
Migraines: Migraines can cause nausea and dizziness in children, as well as headache and sensitivity to light and sound.
Anxiety: Anxiety can trigger nausea and dizziness in children, especially in stressful situations.

11.2. When to Seek Medical Attention

Seek medical attention for your child if they experience any of the following symptoms:

Severe Vomiting: Persistent vomiting that leads to dehydration.
High Fever: Fever above 101°F (38.3°C).
Lethargy: Excessive sleepiness or difficulty waking up.
Headache: Severe headache that does not improve with over-the-counter pain relievers.
Stiff Neck: Stiffness in the neck that may indicate meningitis.
Seizures: Uncontrolled shaking or jerking movements.

11.3. Treatment

Treatment for nausea and dizziness in children depends on the underlying cause.

Rehydration: Provide oral rehydration solutions to prevent dehydration.
Rest: Encourage your child to rest and avoid strenuous activities.
Diet: Offer bland, easily digestible foods such as toast, crackers, and bananas.
Medications: Consult with your pediatrician about appropriate medications to relieve nausea and dizziness.

12. Nausea and Dizziness During Pregnancy

Nausea and dizziness are common symptoms during pregnancy, especially in the first trimester.

12.1. Morning Sickness

Morning sickness is a common condition characterized by nausea and vomiting during pregnancy. It is thought to be caused by hormonal changes.

Symptoms: Nausea, vomiting, and aversion to certain foods.
Management: Eat small, frequent meals, avoid strong odors, and try ginger or peppermint.

12.2. Low Blood Pressure

Pregnancy can cause a drop in blood pressure, leading to dizziness and lightheadedness.

Management: Drink plenty of fluids, avoid standing for long periods, and wear compression stockings.

12.3. Anemia

Anemia, or low iron levels, can cause fatigue, dizziness, and lightheadedness during pregnancy.

Management: Eat iron-rich foods and take iron supplements as prescribed by your healthcare provider.

12.4. When to Seek Medical Attention

Seek medical attention if you experience any of the following symptoms during pregnancy:

Severe Vomiting: Persistent vomiting that leads to dehydration.
Abdominal Pain: Pain in the abdomen that may indicate a more serious condition.
Vaginal Bleeding: Bleeding from the vagina.
Severe Headache: Headache that does not improve with over-the-counter pain relievers.
Vision Changes: Changes in vision such as blurred vision or double vision.

13. FAQ About Nausea and Dizziness

What are the most common causes of nausea and dizziness? Common causes include inner ear problems, dehydration, low blood sugar, migraines, and anxiety.
When should I see a doctor for nausea and dizziness? Seek medical attention if you experience severe symptoms, neurological symptoms, head trauma, or chronic symptoms.
Can medications cause nausea and dizziness? Yes, certain medications can cause nausea and dizziness as side effects.
What are some home remedies for nausea and dizziness? Home remedies include ginger, peppermint, acupressure, and deep breathing.
What is vertigo? Vertigo is the sensation of spinning or whirling, either of yourself or your surroundings.
How can I prevent nausea and dizziness? Preventative measures include staying hydrated, managing blood sugar levels, avoiding triggers, and getting enough sleep.
What foods should I eat when I feel nauseous or dizzy? Bland foods, ginger, peppermint, broth, and bananas are good choices.
What foods should I avoid when I feel nauseous or dizzy? Fatty foods, spicy foods, acidic foods, caffeine, and alcohol should be avoided.
Is nausea and dizziness common during pregnancy? Yes, nausea and dizziness are common during pregnancy, especially in the first trimester.
What tests are used to diagnose the cause of nausea and dizziness? Diagnostic tests include physical examination, blood tests, imaging studies, balance tests, and hearing tests.

14. Conclusion

Experiencing nausea and dizziness can be distressing, but understanding the potential causes and available treatments can empower you to take control of your health. From inner ear issues and dehydration to migraines and anxiety, the reasons behind these symptoms are varied and often interconnected. By seeking timely medical advice and adopting appropriate lifestyle changes, you can effectively manage these conditions and improve your overall well-being.

Remember, WHY.EDU.VN is here to provide you with the knowledge and resources you need to navigate your health concerns. If you’re still searching for answers or need personalized guidance, don’t hesitate to reach out to our experts at 101 Curiosity Lane, Answer Town, CA 90210, United States, or contact us via Whatsapp at +1 (213) 555-0101. Visit our website at why.edu.vn to ask questions and discover a wealth of reliable information tailored to your needs. Your journey to better health starts here.

Alt: A doctor consulting with a patient, underscoring the importance of professional medical advice in diagnosing and managing nausea and dizziness.