Karch's Prep-U (Pharm) CH. 59 Antiemetic Agents
When considering the tendency of antiemetic agents to cross the placenta, which assessment question should the nurse initially ask every childbearing aged woman before initiating the therapy? "Are you pregnant?" "Have you ever been pregnant?" "Do you plan to get pregnant anytime soon?" "Are you aware that this medication crosses the placenta?"
"Are you pregnant?" Explanation: Assess for possible contraindications or cautions that include the current status of pregnancy and lactation because of the potential for adverse effects on the fetus or nursing baby. None of the other questions addresses the status of the woman regarding a current pregnancy.
Which statement made by the parent of a toddler during a discussion on the management of accidental poisoning should be corrected immediately by the nurse? "There is a big risk that the poison could get into the lungs and cause aspiration pneumonia." "I need to keep the telephone number of the poison control center where it is easily accessed." "The American Academy of Pediatrics had changed the guidelines of treating poisonings since I was a child." "I keep a bottle of ipecac syrup locked up but where I can get to it if necessary."
"I keep a bottle of ipecac syrup locked up but where I can get to it if necessary." Explanation: In the summer of 2003 the U.S. Food and Drug Administration released the results of efficacy and toxicity studies done with the emetic drug syrup of ipecac and ruled that the drug was not effective for its intended use and it's been recommends that parents be advised to dispose of any ipecac that they may have at home. The other options present accurate statements regarding the management of an accidental poisoning.
A nurse is caring for a client admitted to the unit for nausea and vomiting who was treated with ondansetron. A friend visiting the client asks the nurse why the client is sleeping. Which is the nurse's best response? "The medication makes the client sleepy by blocking the action of the serotonin receptors." "I have been instructed to allow the client to sleep." "The drug blocks the postganglionic neurons to depress the vomiting center in the brain." "The client is having anticholinergic effects from the medication."
"The medication makes the client sleepy by blocking the action of the serotonin receptors." Explanation: Ondansetron is a serotonin receptor antagonist and works by antagonizing serotonin receptors, preventing their activation by the emetogenic drugs and toxins. The nurse's best response is telling the friend that the medication blocks the action of the serotonin receptors. It does not block the postganglionic neurons to depress the vomiting center in the brain. Ondansetron does not have anticholinergic effects
Which statement, made by an older adult who is prescribed an antiemetic, demonstrates effective medication management by the healthcare provider? "They slowly increased the dose until I stopped vomiting." "I've never experienced any dizziness from the medication." "They gave me the medication in the form of a rectal suppository." "The medication made me only a little sleep."
"They slowly increased the dose until I stopped vomiting." Explanation: The antiemetic dose for older adults should be started at a lower level than that recommended for young adults and adjusted until the desired results are achieved.
A nurse is preparing to administer hydroxyzine to the nauseated client. Which is included in the teaching plan about the medication? "The medication may make you feel more alert, like coffee." "The drug will aid in making you feel less nauseated by stimulating your intestines." "This medication will help with the nausea by making you drowsy." "I will mix this medication with applesauce to help you feel better."
"This medication will help with the nausea by making you drowsy." Explanation: Hydroxyzine works by blocking the action of acetylcholine in the brain, which relieves the nausea and vomiting and causes the client to feel less nauseated and sleepy. Hydroxyzine does not affect the intestines and does not need to be mixed with applesauce or food.
The nurse determines that an IV dose of the phenothiazine, prochlorperazine, has achieved its goal of symptom relief when the client denies any nausea or vomiting within what time frame? Immediately 1-5 minutes 10-20 minutes 30-40 minutes
1-5 minutes Explanation: This antiemetics has an immediate onset if administered IV; 10-20 minutes IM; 30-40 minutes orally.
A patient receives prochlorperazine by IM injection. The nurse would expect the drug to begin acting within which time frame? 10 to 20 minutes 20 to 30 minutes 30 to 40 minutes 40 to 50 minutes
10 to 20 minutes Explanation: Prochlorperazine, when given by IM injection, has an onset of action of 10 to 20 minutes.
A client is undergoing a course of radiotherapy for the treatment of leukemia. Treatments in the past have caused the client severe nausea and vomiting. The oncology nurse should normally administer antiemetics on what schedule? Simultaneous with radiation treatment The night before a scheduled radiation treatment 30 to 60 minutes before the treatment 10 to 15 minutes before the treatment
30 to 60 minutes before the treatment Explanation: The nurse should normally administer antiemetic drugs 30 to 60 minutes before a nausea-producing event, when possible. None of the other options will provide effective nausea and vomiting relief.
A parent of a child who gets carsick is planning on using dimenhydrinate to help the child on a future car trip. When should the nurse tell the parent to administer the medication? 24 hours before the trip 12 hours before the trip 4 hours before the trip 1 hour before the trip
4 hours before the trip Explanation: It takes dimenhydrinate up to 4 hours to be fully effective, so it should be given approximately 4 hours before getting in the car.
The 5-HT3 receptor blocker, palonosetron, is especially suited for administration to which client? A 79 year who is recovering from hip surgery A 16 year old experiencing intractable hiccoughs An 8 year old receiving radiation therapy A 10 month old experiencing vomiting after chemotherapy
A 10 month old experiencing vomiting after chemotherapy Explanation: Palonosetron is approved for use in children 1 month of age and older. None of the other The 5-HT3 receptor blockers have been approved for children under the age of 2 years.
The use of an antiemetic is not clinically safe for which client reporting nausea and vomiting? A client seen in the emergency room for injuries associated with alcohol intoxication A client receiving intensive chemotherapy of metastatic cancer A client experiencing exacerbation of chronic intractable hiccups A postoperative client who underwent a an internal fixation of the femur
A client seen in the emergency room for injuries associated with alcohol intoxication Explanation: Additive CNS depression can be seen with any of the antiemetics if they are combined with other CNS depressants, including alcohol. None of the other client's have an obvious contraindication for this form of medication.
All of the following are centrally acting antiemetics EXCEPT Phenothiazines Anticholinergics Antihistamines Serotonin (5-HT3) receptor blockers Adsorbents
Adsorbents Explanation: Adsorbents act locally by binding to digestive mucus. All other medicals act centrally.
What would increase the risk of sedation in a patient receiving meclizine? (Select all that apply.) Alcohol Diazepam Codeine Hydrocodone Caffeine
Alcohol Diazepam Codeine Hydrocodone Explanation: A patient receiving meclizine has an increased risk of sedation if the patient combines the drug with alcohol, or other drugs that cause CNS depression such as diazepam, codeine, or hydrocodone.
A client is administered a phenothiazine for nausea and vomiting. What is the action of phenothiazine? Increases gastric motility Antagonizes dopamine receptors Blocks histamine receptors Antagonizes serotonin receptors
Antagonizes dopamine receptors Explanation: Phenothiazines act on the chemoreceptor trigger zone CTZ and vomiting center by blocking dopamine. They do not increase gastric motility. Phenothiazines do not block histamine receptors. Phenothiazines do not antagonize serotonin receptors.
When describing dronabinol to a group of students, the instructor emphasizes that this antiemetic is classified as which class of controlled substance? C-I C-II C-III C-IV
C-III Explanation: Dronabinol is classified as a category C-III controlled substance. Nabilone is a category C-II substance. Both drugs are approved for use only in managing the nausea and vomiting associated with cancer chemotherapy in cases that have not responded to other treatment.
When reviewing a newly admitted client's previous medication record, the nurse notes that the client has previously been treated with aprepitant. The nurse is justified in suspecting that this client's medical history includes which therapy/treatment? Placement of a nasogastric tube Chemotherapy Endoscopy Radiation therapy
Chemotherapy Explanation: Prescribers often order aprepitant as part of combination therapy along with a 5-HT3 receptor antagonist and corticosteroids to treat both acute and delayed nausea and vomiting associated with chemotherapy. NG tube insertion, radiation therapy, and endoscopy are not typical indications for the use of aprepitant.
Which statement best compares the use of phenothiazines in treatment as an antiemetic and an antipsychotic? Dosing of phenothiazines is smaller for antiemetics than in antipsychotic use. Antipsychotic phenothiazines affect the histamine response in the body. The phenothiazines for antiemetics block the norepinephrine receptor. Phenothiazines are more effective as antiemetics than antipsychotics.
Dosing of phenothiazines is smaller for antiemetics than in antipsychotic use. Explanation: Doses of phenothiazines are much smaller for antiemetic effect than antipsychotic effects. Phenothiazines act primarily by antagonizing D2 dopamine receptors in the midbrain, decreasing the effect of dopamine in the brain. They also possess muscarinic and histamine blocking effects. Not all phenothiazines are effective as antiemetics.
A nurse administers dronabinol to a patient just prior to starting an infusion of chemotherapy drugs. Before allowing the patient to leave the facility, what should the nurse instruct the patient to avoid? Driving Fluids Sleeping All the above
Driving Explanation: Dronabinol, which may be administered prior to chemotherapy drugs to control nausea and vomiting, can cause dizziness, drowsiness, mood changes, and other mind-altering effects. Patients receiving dronabinol should not drive or perform hazardous tasks requiring alertness, coordination, or physical dexterity, to decrease risks of injury. Additionally, patients should avoid alcohol and other drugs that cause drowsiness.
The nurse is providing education to a client who has been prescribed hydroxyzine. What adverse effect should the nurse mention during teaching? Pruritus Drowsiness Urinary frequency Bradycardia
Drowsiness Explanation: The use of hydroxyzine is associated with drowsiness. Antihistamines do not typically cause pruritus, frequency, or bradycardia.
The nurse administers hydroxyzine to a client with nausea. After administration, the nurse should monitor for what adverse effect? Thrombocytopenia Palpitations Hypertonic muscle tone Dry mouth
Dry mouth Explanation: Anticholinergic effects, including dry mouth, can result from the use of hydroxyzine. This drug is not associated with thrombocytopenia, palpitations, or hypertonicity.
The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2? Fatal hypovolemia secondary to hemorrhage Life-threatening cardiac arrhythmias Fatal respiratory depression Fatal hypertension and subsequent cerebral vascular accident
Fatal respiratory depression Explanation: A black box warning alerts nurses that promethazine is contraindicated in children younger than 2 years of age because of the risk of potentially fatal respiratory depression. When using promethazine, the lowest effective dosage should be used, and other drugs with respiratory depressant effects should not be given concurrently. Excessive doses may cause hallucinations, convulsions, and sudden death.
The nurse is caring for a client who has just had an episode of vomiting. What is the first intervention that the nurse would complete after the client has finished vomiting? Take vital signs. Help the client rinse his mouth. Go prepare an IM injection of an antiemetic. Weigh the client.
Help the client rinse his mouth. Explanation: The nurse should immediately help the client rinse out his mouth which helps take away the taste and sensation of vomit.
The nurse is preparing medications for a client experiencing nausea. Which action will the nurse take when preparing a dose of ondansetron for this client? Crush the tablet before providing. Push the tablet through the foil on the blister pack. Provide fruit juice to be used to ingest the medication. Leave the tablet in the blister pack until just before administration.
Leave the tablet in the blister pack until just before administration. Explanation: Oral ondansetron is well absorbed from the gastrointestinal tract to treat nausea. It is important to leave the disintegrating tablet in the blister pack until administration. The tablet is not crushed before administering because it rapidly dissolves on the tongue. Gentle removal of the tablet from the blister pack is needed; rather than push the pill through the foil backing, the nurse should peel the foil away. Fluids are not required for this medication as it will dissolve on the tongue.
Vomiting occurs when signals from the chemoreceptor trigger zone reach the vomiting center. Where is the vomiting center located? Medulla oblongata Inner ear Cerebral cortex Stomach
Medulla oblongata Explanation: The vomiting center is a nucleus of cells in the medulla oblongata.
A hospitalized toddler has been prescribed an antiemetic. The nurse will implement which intervention based on the child's unique needs? Monitoring for liver dysfunction Providing the child with developmentally appropriate activities Encouraging a family member to stay with the child Monitoring for electrolyte imbalances
Monitoring for electrolyte imbalances Explanation: Antiemetics should be used with caution in children who are at higher risk for adverse effects, including CNS effects, as well as fluid and electrolyte disturbances. The older adult is at risk for liver related issues when prescribed an antiemetic. Both of the remaining options would be appropriate for any hospitalized child.
When educating a patient about antiemetic medications, which of the following information should the nurse include? Most antiemetic medications are better at preventing nausea than treating it. During episodes of vomiting, it is best to continue taking antiemetic medications as prescribed. Activity can help nausea and vomiting subside. Before taking any other medications be sure to consult your health care provider. Tea and gelatins are usually not tolerated well after acute vomiting attacks.
Most antiemetic medications are better at preventing nausea than treating it. Before taking any other medications be sure to consult your health care provider. Explanation: While a patient is having acute episodes of vomiting, it is not advised to take anything by mouth because this may aggravate the gastrointestinal tract and make the vomiting worse. Activity can worsen episodes of nausea and vomiting. Lying down is preferred. Teas, clear liquids, broths, and gelatins are usually tolerated well after attacks of vomiting.
Different medications are used to treat the differing causes of nausea and vomiting. Phenothiazines, although effective against many causes, are usually ineffective in the treatment of nausea and vomiting created by: Motion sickness. Drugs. Surgery. Radiation therapy.
Motion sickness. Explanation: Phenothiazines are usually effective in preventing or treating nausea and vomiting induced by drugs, radiation therapy, surgery, and most other stimuli, but are usually ineffective in motion sickness.
Medications are given post-operatively to prevent or treat severe nausea and vomiting associated with the surgery. What serotonin receptor antagonist would the nurse expect the surgeon to order? Ondansetron Metoclopramide Promethazine Levodopa
Ondansetron Explanation: Ondansetron, granisetron, dolasetron, and palonosetron are used to prevent or treat moderate to severe nausea and vomiting associated with cancer chemotherapy, radiation therapy, and post-operative status.
What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting? Ondansetron Dronabinol Dimenhydrinate Hydroxyzine
Ondansetron Explanation: The 5-HT3 receptor antagonists are usually considered drugs of first choice for postoperative nausea and vomiting. Ondansetron is the prototype of the 5-HT3 receptor antagonists. None of the remaining options are a 5-HT3 receptor antagonist.
Which would an instructor include as an example of a phenothiazine used as an antiemetic? Perphenazine Granisetron Cyclizine Metoclopramide
Perphenazine Explanation: Perphenazine is a phenothiazine antiemetic. Granisetron is classified as a 5-HT3 receptor blocker. Cyclizine is an anticholinergic/antihistamine antiemetic. Metoclopramide is a nonphenothiazine antiemetic.
A client has been prescribed a phenothiazine for chemotherapy related nausea and vomiting. Which urinary side effect should the nurse include when educating the client on this medication? Temporary urinary burning Pink to red brown urine Urinary frequency Urinary urgency
Pink to red brown urine Explanation: Patients taking a phenothiazine should be cautioned that their urine may be tinged pink to red-brown. This is a drug effect but can cause concern if the patient is not expecting it. None of the other options are associated with this classification of medication.
A client has been told that stimulation of their chemoreceptor trigger zone (CTZ) is responsible for their current symptoms. What nursing action indicates that the nurse is aware of the role of the CTZ? Assessing skin for signs of photosensitivity Planning care to manage the client's nausea and vomiting Assessing the client for indications of cardiac arrhythmias Planning interventions to address safety issues associated with orthostatic hypotension
Planning care to manage the client's nausea and vomiting Explanation: The CTZ, located in the brain is referred to as the vomiting center. Nausea and vomiting are experienced when this center is stimulated. The remaining options are associated with adverse reactions to antiemetic medications.
An older adult client with severe dementia has been experiencing repeated vomiting. What antiemetic drug has a black box warning against use in a client of this age? Prochlorperazine Benzquinamide Buclizine Cyclizine
Prochlorperazine Explanation: A black box warning alerts nurses that use of prochloperazine in older adults with dementia-related psychosis can result in death. Benzquinamide, buclizine, and cyclizine do not have such warnings.
A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which nursing diagnoses should the nurse prioritize for this client's care plan? Risk for imbalanced fluid volume Disturbed sensory perception Impaired physical mobility Ineffective tissue perfusion
Risk for imbalanced fluid volume Explanation: The care plan should include risk for imbalanced fluid volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which nursing diagnoses should the nurse prioritize for this client's care plan? Risk for imbalanced fluid volume Disturbed sensory perception Impaired physical mobility Ineffective tissue perfusion
Risk for imbalanced fluid volume Explanation: The care plan should include risk for imbalanced fluid volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
Which intervention has priority when caring for an older adult client who has been prescribed a phenothiazine for reported nausea? The client is identified as a possible falls risk Frequent oral care to manage oral dryness Monitoring the client for signs of anorexia Assessing the client for pink tinged urine
Risk for imbalanced fluid volume Explanation: The care plan should include risk for imbalanced fluid volume for the client receiving an antiemetic due to the possible fluid losses associated with vomiting as well as the possible decrease in fluid intake. Disturbed sensory perception, impaired physical mobility, and ineffective tissue perfusion are not applicable.
Ondansetron (Zofran) belongs to which pharmacological category of medications? Selective 5-HT3 receptor antagonist Prokinetic Anticholinergic Dopamine receptor antagonist
Selective 5-HT3 receptor antagonist Explanation: Ondansetron (Zofran) is a selective 5-HT3 receptor antagonist.
A client who received palonosetron prior to a chemotherapy session asks the nurse if she can have a prescription for this drug in case she has nausea and vomiting over the next several days. Which of the following would the nurse need to keep in mind when responding to the client? The drug can be given for two or three more doses. The drug is limited to the days that chemotherapy is given. Seven days must pass before a repeat dose can be given. The drug is a controlled substance.
Seven days must pass before a repeat dose can be given. Explanation: Palonosetron cannot be repeated for 7 days. The drug is not a controlled substance. Granisetron is used only on the days that chemotherapy is given. Metoclopramide typically is given as one dose 30 minutes before chemotherapy, then every 2 hours for two doses, then every 3 hours for three doses.
Which client is a candidate for cannabis therapy? Select all that apply. The 16 year old with medication resistant cancer pain The 55 year old with AIDS related anorexia The 35 year double amputee for post surgical pain A 25 year old asthmatic who is 12 hours post appendectomy A 78 year old diagnosed with terminal brain cancer
The 16 year old with medication resistant cancer pain The 55 year old with AIDS related anorexia A 78 year old diagnosed with terminal brain cancer Explanation: The U.S. Food and Drug Administration has approved the use of the active ingredient in cannabis, delta-9-tetrahydrocannabinol, in an oral form for the relief of nausea and vomiting in cancer patients who have not responded to other therapies and for the treatment of anorexia associated with AIDS. It is not approved for use in the postoperative setting.
A client, scheduled to begin chemotherapy for the treatment of breast cancer, is anxious about the possibility of experiencing nausea. When explaining the physiology of nausea and vomiting, the nurse should include what information? The vomiting center is a cluster of cells in the cerebellum The chemoreceptor trigger zone (CTZ) plays a key role in nausea The chemoreceptor trigger zone (CTZ) exists in the fundus of the stomach and the duodenum The vomiting center exists in the soft palate and esophagus
The chemoreceptor trigger zone (CTZ) plays a key role in nausea Explanation: The CTZ is composed of neurons that play a major role in affecting nausea and vomiting. Neither the CTZ nor the vomiting center exist within the GI tract. The CTZ is not in the cerebellum, which primarily modulates balance.
The nurse is discussing the possible side effects of chemotherapy with a client. What information obtained during the client's admission assessment and interview will have a direct influence on the management of nausea and vomiting The cancer has been identified at stage 2 There is a history of cancer in the client's family The client has been prescribed phenothiazine for anxiety The client has identified several food allergies
The client has been prescribed phenothiazine for anxiety Explanation: Phenothiazine is antianxiety drug that blocks the responsiveness of the CTZ to stimuli, leading to a decrease in nausea and vomiting. None of the other options are related to chemotherapy induced nausea and vomiting.
The nurse is preparing to provide a client, experiencing intractable hiccups, medication information regarding a prescribed phenothiazine. What information should the nurse provide? Select all that apply. The medication affects the brain's medulla The medication is used cautiously during pregnancy and lactation Phenothiazine is recommended for clients who have experienced brain injury The medication is contraindicated in clients experiencing renal dysfunction The medication has been associated with cardiac arrhythmias
The medication affects the brain's medulla The medication is used cautiously during pregnancy and lactation The medication is contraindicated in clients experiencing renal dysfunction The medication has been associated with cardiac arrhythmias Explanation: Phenothiazines are centrally acting antiemetics that change the responsiveness or stimulation of the CTZ in the medulla. Caution should be used in individuals with renal dysfunction or during pregnancy and lactation because of the potential for adverse effects on the fetus or baby. Other, not uncommon adverse effects include cardiac arrhythmias. In general, antiemetics should not be used in patients who have experienced brain damage or injury because of the risk of further CNS depression.
In which of the following scenarios would the nurse question the order for ondansetron (Zofran)? Treatment of gastresophageal reflux Treatment of nausea and vomiting as a result of chemotherapy Prevention of nausea and vomiting from chemotherapy Prevention of postoperative nausea or vomiting
Treatment of gastresophageal reflux Explanation: Because the mechanism of action of ondansetron (Zofran) does not act directly on the gastrointestinal system as other antiemetics do, the nurse should question this order as a treatment for gastresophageal reflux.
Metoclopramide is classified as a nonphenothiazine antiemetic. True False
True The only nonphenothiazine currently available for use as an antiemetic is metoclopramide.
The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea? Polyuria Hematuria Urinary retention Dysuria
Urinary retention Explanation: Promethazine may cause urinary retention, which may be problematic in a client who already has benign prostatic hypertrophy.
The nurse is caring for a male client who has benign prostatic hypertrophy. The nurse would be alert for what complication if this client is given promethazine for treatment of nausea? Polyuria Hematuria Urinary retention Dysuria
Urinary retention Explanation: Promethazine may cause urinary retention, which may be problematic in a client who already has benign prostatic hypertrophy.
A male client has been receiving promethazine for nausea that occurred following chemotherapy. Recently it has been discovered that this client has developed liver dysfunction. The nurse anticipates that the health care provider will do what to treat this client's nausea? Use an alternative medication. Increase the dose of the medication. Decrease the dose of the medication. Maintain the current dose of the medication.
Use an alternative medication. Explanation: Phenothiazines are metabolized in the liver and eliminated in urine. In the presence of liver disease (e.g., cirrhosis, hepatitis), metabolism may be slowed and drug elimination half-lives prolonged, with resultant accumulation and increased risk of adverse effects. Therefore, the drugs should be used cautiously in clients with hepatic impairment. Cholestatic jaundice has been reported with promethazine.
A nurse is preparing to administer dolasetron orally to a child who is unable to swallow the tablet. The nurse would expect to mix the solution with: apple juice. cranberry juice. orange juice. grapefruit juice.
apple juice. Explanation: Dolasetron solution can be mixed with apple or apple-grape juice for administration.
A client develops intractable hiccoughs after surgery. The nurse anticipates the primary health care provider will order which drug? metoclopramide chlorpromazine dolasetron granisetron
chlorpromazine Explanation: Chlorpromazine is a phenothiazine; phenothiazines are the drug of choice for intractable hiccoughs. Metoclopramide, dolasetron, and granisetron would not be acceptable for this client's condition. Metoclopramide is a dopamine antagonist used to treat gastroesophageal reflux. Dolasetron and granisetron are 5-HT3 antagonists used to treat nausea and vomiting.
The nurse is providing education to a client who has been newly prescribed chlorpromazine to prevent motion sickness while traveling. The nurse would instruct the client to take the medication 30 minutes before travel and again at what interval? as often as needed every 3 to 4 hours every 4 to 6 hours up to twice daily
every 4 to 6 hours Explanation: For prevention of motion sickness, the nurse would recommend antiemetics be taken 30 minutes before travel and then every 4 to 6 hours, if necessary. The nurse would not recommend taking them as suggested by any of the other options since more frequently would be unsafe and less frequently would compromise effectiveness.
A client reports taking antihistamines to treat nausea. The nurse correctly suspects that the nausea results from what trigger? surgery. motion sickness. drugs. radiation therapy.
motion sickness. Explanation: Antihistamines are usually effective in preventing or treating nausea and vomiting induced by motion sickness. They are not prescribed for nausea triggered by drugs, surgery, or radiation therapy.
What are the most common adverse effects associated with drug therapy? nausea and vomiting lethargy and elevated temperature elevated temperature and anorexia respiratory depression and skin rash
nausea and vomiting Explanation: Nausea and vomiting are the most common adverse effects of drug therapy. While the other options are possible, they are not as common as is nausea and vomiting.
A client is experiencing nausea and vomiting as a response to radiation therapy. Which antiemetic agent is a phenothiazine administered to control nausea and vomiting? prochlorperazine metoclopramide mesna dexamethasone
prochlorperazine Explanation: Prochlorperazine is a commonly used phenothiazine administered for nausea and vomiting related to radiation therapy. Metoclopramide is a prokinetic agent that increases GI motility and the rate of gastric emptying by increasing the release of acetylcholine from nerve endings in the GI tract. Mesna is used for thrombocytopenia. Dexamethasone is a corticosteroid.
An older adult client with early-stage Alzheimer's disease has had hydroxyzine prescribed for nausea. When planning this client's care, the nurse should consequently identify what risk nursing diagnosis? risk for falls related to adverse effects of hydroxyzine risk for infection related to adverse effects of hydroxyzine risk for impaired skin integrity related to adverse effects of hydroxyzine risk for functional urinary incontinence related to adverse effects of hydroxyzine
risk for falls related to adverse effects of hydroxyzine Explanation: With hydroxyzine, adverse anticholinergic effects include drowsiness, dizziness, confusion, and blurred vision. These reactions increase the risk for falls, especially in the case of a client with an underlying cognitive disorder. Use of the drug does not increase the risk for infection, impaired skin integrity, or urinary incontinence.
The nurse is caring for a patient who is receiving ondansetron IV for treatment of nausea. The nurse can be confident that treatment is effective when: the patient's heart rate falls to 65 bpm. the patient's blood pressure does not exceed 110/65 mm Hg. the patient expresses hunger. the patient states that nausea has decreased.
the patient states that nausea has decreased. Explanation: Nausea is an unpleasant sensation of abdominal discomfort accompanied by a desire to vomit. The most reliable indication of effective therapy is the patient's statement that nausea has decreased. Ondansetron would not alter blood pressure, heart rate, or sensation of hunger in the patient.
The nurse is educating a female client regarding a new prescription for aprepitant. What information should the nurse include in the teaching? Select all that apply. the high risk for dependence the potential for significant drug interactions the possibility of dizziness as an adverse effect the fact that the drug is pregnancy category X the drug's effect on oral contraception effectiveness
the potential for significant drug interactions the possibility of dizziness as an adverse effect the drug's effect on oral contraception effectiveness Explanation: Aprepitant produces significant interactions that alter the effectiveness of other medications. The drug reduces the effectiveness of oral contraceptives for up to 28 days after administration; therefore, alternate contraceptive methods are recommended during treatment and for 1 month following administration of aprepitant. It is approved for use and is pregnancy category B. It does not have a high potential for dependence. Aprepitant is well tolerated, with the most common adverse effects being fatigue, weakness, dizziness, abnormal heart rhythm, headache, and hiccups.
