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A client is receiving an antiemetic. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements? Which of the following would the nurse include in the client's plan of care?
- A. Remove items with strong smells and odors.
- B. Use mouthwash or frequent oral rinses.
- C. Make the environment as pleasant as possible.
- D. Explain that the drug may change the color of the stool.
- E. Follow the medication with a small amount of water.
Correct Answer: A,B,C
Rationale: When caring for a client receiving an antiemetic with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements, the nurse makes the environment as pleasant as possible to enhance the client's appetite and removes items with strong smells and odors. The nurse gives the client mouthwash or frequent oral rinses to remove the disagreeable taste that accompanies vomiting. Stool color is unaffected. Liquid antacids could be followed with a small amount of water.
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A nurse is caring for an elderly client who has received cimetidine. Which of the following interventions should the nurse perform?
- A. Monitor the client for complaints of pain or sour taste.
- B. Monitor the client for concentrated urine and restlessness.
- C. Closely monitor the client for confusion and dizziness.
- D. Report symptoms of tardive dyskinesia to the primary health care provider.
Correct Answer: C
Rationale: The nurse should closely monitor the elderly client who has been administered cimetidine for confusion and dizziness. When the client is receiving an antiemetic, the nurse monitors the client frequently for continued complaints of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the client, the nurse should observe the client for concentrated urine and restlessness. When the client is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the primary health care provider.
A nurse should monitor a client taking which of the following drugs for increased adverse effects and toxicity if omeprazole (Prilosec) therapy is initiated?
- A. Phenobarbital (Luminal)
- B. Digoxin (Lanoxin)
- C. Diazepam (Valium)
- D. Warfarin (Coumadin)
- E. Ketoconazole (Nizoral)
Correct Answer: B,C,D
Rationale: The initiation of proton pump inhibitors, like omeprazole (Prilosec), can result in increased adverse reactions and toxicities of warfarin (Coumadin), benzodiazepines (diazepam), digoxin (Lanoxin), phenytoin (Dilantin), and clarithromycin (Biaxin).
A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which of the following nursing diagnoses should the care plan for this client include?
- A. Risk for Imbalanced Fluid Volume
- B. Disturbed Sensory Perception
- C. Impaired Physical Mobility
- D. Ineffective Tissue Perfusion
Correct Answer: A
Rationale: 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 is caring for a client who has been prescribed aluminum carbonate gel (Basaljel) for the relief of an acute peptic ulcer. Which of the following interventions should the nurse perform to promote an optimal response to therapy?
- A. Administer the drug hourly for the first 2 weeks.
- B. Administer the drug early in the morning before breakfast.
- C. Administer the drug with 40 mL of apple juice.
- D. Administer the first dose by IV route and then orally.
Correct Answer: A
Rationale: The nurse should administer the drug hourly for the first 2 weeks when treating an acute peptic ulcer. The nurse instructs the client to administer the drug 1 to 2 hours after meals and at bedtime after the first 2 weeks. The nurse need not suggest to the client to administer the drug early to the morning before breakfast nor to administer it with apple juice. The drug is not given intravenously.
A client with a nasogastric tube is prescribed therapy to prevent ulcer development. Which of the following would be the best option for the drug?
- A. Tablet that can be crushed
- B. Liquid formulation
- C. Intravenous administration
- D. Intramuscular injection
Correct Answer: B
Rationale: The nurse should request the liquid form when administration is in a tube to decrease the chance of a clogged NG tube. Although it is appropriate to crush the tablet and mix it with apple juice, there is still a risk for clogging. Intravenous or intramuscular administration would be inappropriate. The IV route is typically preferred if the patient has an existing IV line, because these drugs are irritating, and IM injections need to be given deep into the muscular tissue to minimize harm.