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A patient is taking chemotherapy with a drug that has a high potential for causing nausea and vomiting. The nurse is preparing to administer an antiemetic drug. Which class of antiemetic drugs is most commonly used to prevent nausea and vomiting for patients receiving chemotherapy?
- A. Prokinetic drugs, such as metoclopramide
- B. Serotonin blockers, such as ondansetron
- C. Anticholinergic drugs, such as scopolamine
- D. Neuroleptic drugs, such as promethazine
Correct Answer: B
Rationale: Serotonin blockers are used to prevent chemotherapy-induced and postoperative nausea and vomiting.
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An adult patient is about to receive intravenous (IV) ondansetron during a chemotherapy treatment. A dose of 0.15 mg/kg IV 30 minutes before chemotherapy is ordered. The patient weighs 165 pounds. The medication is supplied in a vial marked 2 mg/mL for IV administration. Identify how many milliliters the nurse will administer for this dose. (Record answer to one decimal place.)
Correct Answer: 5.7 mL
Rationale: Convert pounds to kilograms: 165 ?· 2.2 = 75 kg. Calculate milligrams per dose: 0.15 mg/kg ?? 75 kg = 11.25 mg, rounded to 11.3 mg/dose. Calculate milliliters to be given: 2 mg:1 mL::11.3 mg:x mL, (2 ?? x) = (1 ?? 11.3); 2x = 11.3, x = 5.65, which rounds to 5.7 mL.
A patient with motion sickness is planning a cross-country car trip and has a new prescription for a scopolamine transdermal patch. The nurse provides teaching for the use of this patch medication. The patient shows a correct understanding of the teaching with which statement?
- A. I will change the patch every day.
- B. I will change the patch every other day.
- C. I will change the patch every 3 days.
- D. I will remove the patch only if it stops working.
Correct Answer: C
Rationale: Scopolamine patches are 72-hour doses and therefore are changed every 3 days.
A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a chemotherapy drug that is known to be highly emetogenic. The nurse will implement which interventions regarding the pharmacologic management of nausea and vomiting? (Select all that apply.)
- A. Giving antinausea drugs at the beginning of the chemotherapy infusion
- B. Administering antinausea drugs 30 to 60 minutes before chemotherapy is started
- C. For best therapeutic effects, medicating for nausea once the symptoms begin
- D. Observing carefully for the adverse effects of restlessness and anxiety
- E. Instructing the patient that the antinausea drugs may cause extreme drowsiness
- F. Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotension
Correct Answer: B,E,F
Rationale: Antiemetics should be given before any chemotherapy drug is administered, often 30 to 60 minutes before treatment, but not immediately before chemotherapy is administered. Do not wait until the nausea begins. Most antiemetics cause drowsiness, not restlessness and anxiety. Orthostatic hypotension is a possible adverse effect that may lead to injury.
A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug. The nurse will include which information when teaching the patient about this drug?
- A. The patient may skip doses if the patient is feeling well.
- B. The patient will need to avoid driving because of possible drowsiness.
- C. The patient may experience occasional problems with taste.
- D. It is safe to take the medication with a glass of wine in the evening to help settle the stomach.
Correct Answer: B
Rationale: Drowsiness may occur because of central nervous system (CNS) depression, and patients should avoid driving or working with heavy machinery because of possible sedation. These drugs must not be taken with alcohol or other CNS depressants because of possible additive depressant effects. The medication should be taken as instructed and not skipped unless instructed to do so.
A patient on chemotherapy is using ondansetron for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect of this drug?
- A. Dizziness
- B. Diarrhea
- C. Dry mouth
- D. Blurred vision
Correct Answer: B
Rationale: Diarrhea is an adverse effect of the serotonin blockers. The other adverse effects listed may occur with anticholinergic drugs.