Nokea
A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state. The nurse anticipates an order for which antinausea drug to stimulate his appetite?
- A. Metoclopramide, a prokinetic drug
- B. Dronabinol, a tetrahydrocannabinoid
- C. Ondansetron, a serotonin blocker
- D. Aprepitant, a substance P/NK1 receptor antagonist
Correct Answer: B
Rationale: Dronabinol is used for the treatment of nausea and vomiting associated with cancer chemotherapy, generally as a second-line drug after treatment with other antiemetics has failed. It is also used to stimulate appetite and weight gain in patients with AIDS and in patients undergoing chemotherapy.
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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.
The nurse is reviewing new postoperative orders and notes that the order reads, 'Give hydroxyzine 50 mg IV PRN nausea or vomiting.' The patient states that he has slight nausea. Which action by the nurse is correct at this time?
- A. Hold the dose until the patient states that the nausea is severe.
- B. Give the dose orally instead of intravenously.
- C. Give the patient the IV dose of hydroxyzine as ordered.
- D. Call the prescriber to question the route that is ordered.
Correct Answer: D
Rationale: The nurse needs to question the route. Hydroxyzine is an antihistamine-class antiemetic that is only to be given either by oral or intramuscular routes. Intravenous, intra-arterial, or subcutaneous administration of hydroxyzine may result in significant tissue damage, thrombosis, and gangrene. Antiemetic drugs are best given before the patient's nausea becomes severe.
A patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of drug will be used to promote gastric emptying for this patient?
- A. Prokinetic drugs, such as metoclopramide
- B. Serotonin blockers, such as ondansetron
- C. Anticholinergic drugs, such as scopolamine
- D. Neuroleptic drugs, such as chlorpromazine
Correct Answer: A
Rationale: Prokinetic drugs promote the movement of substances through the gastrointestinal tract and increase gastrointestinal motility.
A patient who has severe nausea and vomiting following a case of food poisoning comes to the urgent care center. When reviewing his medication history, the nurse notes that he has an allergy to procaine. The nurse would question an order for which antiemetic drug if ordered for this patient?
- A. Metoclopramide
- B. Promethazine
- C. Phosphorated carbohydrate solution
- D. Palonosetron
Correct Answer: A
Rationale: The use of metoclopramide is contraindicated in patients with a hypersensitivity to procaine or procainamide.
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.