Certified Hospice and Palliative Assistant (CHPNA) Practice Test

What is a common cause of hiccoughs in a patient with ascites?

1. Stomach irritation only

2. Phrenic and vagus nerve irritation

3. Excessive drinking of water

4. Increased anxiety

The correct answer is: Phrenic and vagus nerve irritation

A common cause of hiccoughs in a patient with ascites is phrenic and vagus nerve irritation. Ascites is the abnormal accumulation of fluid in the abdominal cavity, which can lead to increased pressure on surrounding structures, including the diaphragm. The diaphragm is innervated by the phrenic nerve, and if this nerve is stimulated or irritated, it can trigger diaphragm spasms, resulting in hiccoughs. Additionally, the vagus nerve, which also plays a role in gastrointestinal function and can influence the diaphragm, may similarly experience irritation due to the distension of the abdomen and surrounding organs. The interaction of these nerves with the fluid buildup directly links phrenic and vagal nerve irritation with the onset of hiccoughs in patients with ascites. This understanding highlights the importance of considering the physiological implications of ascites when evaluating symptoms like hiccoughs, emphasizing how systemic conditions can lead to surprising and interconnected symptoms.