Nokea
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.
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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 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.
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.
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 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.