Prep U chapter 59

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?"

A female patient has been administered metoclopramide (Reglan) for nausea. Which statements indicates that she has understood the teaching provided by the nurse?

"I may experience drowsiness with this medication."

The nurse is providing education to a client who has been prescribed hydroxyzine. Which statement indicates that the client has understood the teaching?

"I may experience drowsiness with this medication."

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."

A nurse is preparing to administer hydroxyzine to the nauseated client. Which is included in the teaching plan about the medication?

"This medication will help with the nausea by making you drowsy."

A client receiving chemotherapy has begun receiving aprepitant. The client also takes oral contraceptives. What should the nurse tell the client in regard to birth control?

"Use alternative means of birth control for 1 month after taking aprepitant."

A patient receives prochlorperazine by IM injection. The nurse would expect the drug to begin acting within which time frame?

10 to 20 minutes

The order for the patient reads: ondansetron (Zofran) 2 mg IV now. The vial of Zofran on the floor contains 4mg/5mL. How many mL should be administered?

2.5

A client has requested an oral antiemetic to control motion sickness on an upcoming flight. While explaining proper use of the drug, the nurse should recommend that the client take the drug:

30 minutes prior to the flight.

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?

30 to 60 minutes before the treatment

A client is to start receiving chemotherapy at 10:00 AM. The client has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time?

9:30 AM

The 5-HT3 receptor blocker, palonosetron, is especially suited for administration to which client?

A 10 month old experiencing vomiting after chemotherapy

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 patient is administered metoclopramide (Reglan). The patient has an elevated creatinine level. Which of the following is important when administering metoclopramide to this patient?

Administer a lower dose

All of the following are centrally acting antiemetics EXCEPT

Adsorbents

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

Which agent would the nurse identify as acting directly in the central nervous system to block receptors associated with nausea and vomiting with little to no effect on serotonin, dopamine, or corticosteroid receptors?

Aprepitant

A client is receiving a phenothiazine antiemetic. The nurse instructs the client to use the call light if he needs to get out of bed to go to the bathroom based on the understanding that this group of drugs is associated with:

Central nervous system effects

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?

Chemotherapy

Which is a side effect a nurse should recognize after administration of hydroxyzine?

Client rubbing eyes, reporting blurry vision.

What is the best indicator of decreased nausea after administering ondansetron (Zofran) IV?

Client states, "I feel less nauseated."

Which statement best identifies the FDA black box warning for perphenazine?

Death can occur with older adult clients who receive perphenazine.

A patient develops significant nausea and vomiting related to antineoplastic chemotherapy. Which agent would be most appropriate to use in this situation? (Select all that apply.) Dolasetron Granisetron Aprepitant Nabilone Hydroxyzine

Dolasetron Granisetron Aprepitant Nabilone

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.

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

The nurse is providing education to a client who has been prescribed hydroxyzine. What adverse effect should the nurse mention during teaching?

Drowsiness

People taking phenothiazines need to be assessed for extrapyramidal symptoms. What effects are considered adverse effects of the phenothiazines?

Dry mouth, dizziness, and urinary retention

Which practice reported by a parent requires immediate attention by the nurse?

Encouraging their child to take prescribed medication by referring to it as candy

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 respiratory depression

A nurse is preparing to administer ondansetron to a client with vomiting. A nurse should be aware of what drug-related information before administering ondansetron? Select all that apply. For pediatric clients, ondansetron can be used safely. No dosage adjustment is necessary for older adult clients. Constipation is a common adverse effect of the medication. The medication may decrease mental alertness. St. John's wort should be used judiciously with the medication.

For pediatric clients, ondansetron can be used safely. No dosage adjustment is necessary for older adult clients. Constipation is a common adverse effect of the medication. The medication may decrease mental alertness

After reviewing the various agents used as antiemetics, a group of students demonstrate understanding of the information when they identify which agent as a 5-HT3 receptor blocker?

Granisetron

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?

Help the client rinse his mouth.

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?

Leave the tablet in the blister pack until just before administration.

Vomiting occurs when signals from the chemoreceptor trigger zone reach the vomiting center. Where is the vomiting center located?

Medulla oblongata

Which part of the brain is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting?

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 electrolyte imbalances

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.

What antiemetic is the most common first-line drug for the treatment of postoperative nausea and vomiting?

Ondansetron

Which would an instructor include as an example of a phenothiazine used as an antiemetic?

Perphenazine

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?

Pink to red brown urine

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?

Planning care to manage the client's nausea and vomiting

A client prescribed promethazine has an elevated creatinine level. Which action is the health care provider likely to take considering any possible related risk to this client?

Prescribe administration of a lower dose

Why is buclizine an effective antiemetic?

Promotes anticholinergic effects

The home care nurse is visiting a client who is receiving antiemetics. Which actions will the nurse perform to ensure safe and effective treatment for the client? (Select all that apply.)

Reinforce teaching about dosage. Encourage client to sip on clear fluids to prevent dehydration. Do not drive while taking antinausea medicine.

Ondansetron (Zofran) belongs to which pharmacological category of medications?

Selective 5-HT3 receptor antagonist

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 client has been prescribed phenothiazine for anxiety

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

In which of the following scenarios would the nurse question the order for ondansetron (Zofran)?

Treatment of gastresophageal reflux

Metoclopramide is classified as a nonphenothiazine antiemetic.

True

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?

Urinary retention

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.

Which instruction would be most appropriate for the nurse to give to a patient who is experiencing photosensitivity related to antiemetic therapy?

Use protective sunscreen when outside.

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.

A client reports taking antihistamines to treat nausea. The nurse correctly suspects that the nausea results from what trigger?

motion sickness.

A nurse is caring for a 16-month-old client that recently underwent myringotomy surgery. Which antiemetic is contraindicated?

promethazine

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

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 states that nausea has decreased.