Pharm Chapter 59
A patient receives prochlorperazine rectally at 6pm. The nurse would expect the drug to begin acting at approximately which time? 6:15pm 6:45pm 7:15pm 8:00pm
7:15pm
A patient is to start receiving chemotherapy at 10:00 am. The patient has an order for intravenous metoclopramide. The nurse would expect to give the drug at which time? 9:00 am 9:30 am 10:15 am 11:00 am
9:30 am
When reviewing the medical record of a patient who is to receive promethazine, which of the following would indicate to the nurse that the patient needs to be monitored closely? Active peptic ulcer disease Severe hypotension Brain injury Coma
Active peptic ulcer disease
Antiemetic
Agent that blocks the hyperactive response of the CTZ Produces non-beneficial N/V
Emetic
Agent used to induce vomiting To rid stomach of toxins or drugs
A patient is receiving meclizine. The nurse would caution the patient to avoid which of the following? Caffeine Chocolate Alcohol Aged cheese
Alcohol
Phenothiazine
Anti-anxiety drug that blocks the responsiveness of the CTZ to stimuli Leading to a decrease in N/V
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 side effect on serotonin, dopamine, or corticosteroid receptors? Metoclopramide Aprepitant Meclizine Granisetron
Aprepitant
Substance P/Neurokinin 1 Receptor Antagonists
Aprepitant Action: Act directly in the CNS to block receptors assocaited with N/V Indications: in combo with other agents to prevent N/V in chemotherapy Adverse effects: Anorexia, fatigue, headache, constipation, diarrhea, gastritis, liver enzyme elevation, dehydration
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
A patient is receiving a phenothiazine antiemetic. The nurse instructs the patient to use the call light if he needs to get out of bed to use the bathroom based on that understanding that this group of drugs is associated with which of the following? Gastrointestinal overstimulation Central nervous system effects Urinary abnormalities Endocrine effects
Central nervous system effects
When describing the action of prochlorperazine, which of the following would the nurse include as being affected? Local response to stimuli Chemoreceptor trigger zone Cerebru Medulla
Chemoreceptor trigger zone
The nurse is assessing a patient who is receiving aprepitant for adverse effects. Which of the following would the nurse expect to find? Select all that apply. Dizziness Dry mouth Constipation Anorexia Headache Irritability
Constipation Anorexia Headache Irritability
The nurse would expect a patient with motion sickness to receive which of the following ? Promethazine Dolasetron Perphenzine Cyclizine
Cyclizine
1. Nursing interventions for the client receiving an antiemetic drug would include which of the following? Frequent mouth care Bowel program to deal with constipation Protection from falls or injury Fluids to guard against dehydration Protection from sun exposure Quiet environment and temperature control
Frequent mouth care Protection from falls or injury Fluids to guard against dehydration Protection from sun exposure Quiet environment and temperature control
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-HT receptor blocker? Chlorpromazine Cyclizine Granisetron Aprepitant
Granisetron
Photosensativity
Hypersensitive reaction to the sun or UV light
A patient is receiving palonosetron. The nurse would expect to administer this drug by which route? Oral Intramuscular Subcutaneous Intravenous
Intravenous
Anticholinergics/Antihistamines
Meclizine Action: Anticholinergics that act as antihistamines and block the transmission of impulses to the CTZ Indications: prevention and treatment of N/V in motion sickness Adverse effects: Drowsiness, confusion, dry mouth, nasal congestion, sweating , urine retention, respiratory depression
Nonphenothiazines
Metoclopramide Action: acts to reduce the responsiveness of the nerve cells in the CTZ to circulating chemicals that induce vomiting Indications: prevention of N/V in motion sickness Adverse effects: drowsiness, fatigue, restlessness, extrapyramidal symptoms, diarrhea
1. The nurse anticipates that prochlorperazine (Compazine) would be the antiemetic of choice for which of the following? Nausea and vomiting after anesthesia Nausea and vomiting due to cancer chemotherapy Motion sickness Intractable hiccoughs
Nausea and vomiting after anesthesia
2. Palonosetron (Aloxi) would be a drug of choice for a client with which of the following problems? Nausea and vomiting associated with cancer chemotherapy A prolonged Q-T interval Delayed nausea and vomiting associated with antineoplastic chemotherapy Difficulty swallowing Hypokalemia Hypomagnesemia
Nausea and vomiting associated with cancer chemotherapy Delayed nausea and vomiting associated with antineoplastic chemotherapy
A patient is receiving an antiemetic. Which of the following would be most appropriate to facilitate the patients comfort? Offering carbonated drinks Encouraging rapid, shallow breathes Distracting the patient with activities Offering mouth care every 4-6 hours
Offering carbonated drinks
Serotonin (%-HT3) Receptor Blockers
Ondansetron Action: BLock those receptors associated with N/V in the CTZ Indications: Control of N/V in chemo, radition, and post-op Adverse effects: headache, drowsiness, myalgia, rash, urinary retention, constipation, pain at the injection site, hypotension
Phenothiazines
Prochlorperazine Action: depress responsiveness or stimulation of the CTZ in the medulla Indications: treatment of nausea and vomiting Contraindications: Severe CNS depression, brain injury, hypotnesion, hypertension, renal or liver imapirment, active peptic ulcer Adverse effects: Drowsy, dizzy, weak, tremor, hypotension, hypertension, cardiac arrhythmia, dry mouth, stuffy nose, sweating, urinary retention, pink tinged urine, menstrual disorders, photosensitivity
Vestibular
Referring to the apparatus of the inner ear that controls balance and sense of motion Can cause motion sickness
Intractable Hiccough
Repetitive stimulation of the diaphragm
A patient 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 patient? Seven days must pass before a repeat dose can be given The drug is a controlled substance The drug is limited to the days that chemotherapy is given The drug can be given for two or three more doses
Seven days must pass before a repeat dose can be given
After reviewing information about various antiemetic agents, a group of students demonstrate understanding of the information when they identify which drug as similar to antihistamines but not as sedating ? Hydroxyzine Nabilone Trimethobenzamide Dronabinol
Trimethobenzamide
3. Which of the following instructions would be most appropriate to give to a patient to reduce the risk of photosensitivity related to the use of antiemetic agents? Avoid having their picture taken. Cover the head at extremes of temperature. Take extra precautions to avoid heat stroke. Wear protective clothing when in the sun.
Wear protective clothing when in the sun.
4. The 5-HT3 receptor blockers, including ondansetron (Zofran) and granisetron (Kytril), are particularly effective in decreasing the nausea and vomiting associated with...? vestibular problems. cancer chemotherapy. pregnancy. severe pain.
cancer chemotherapy.
5. A parent calls with concerns that a 2-year-old child ate a bottle full of baby aspirin. The nurse would advise the parent to...? administer ipecac immediately. induce vomiting by inserting a finger against the back of the child's throat. force fluids as the parent brings the child in for evaluation. feed the child charcoal.
force fluids as the parent brings the child in for evaluation.
2. Most antiemetics work with the central nervous system to decrease the activity of...? the medulla. the chemoreceptor trigger zone. the respiratory center. the sympathetic nervous system.
the chemoreceptor trigger zone.
