Nokea
A woman who is in the first trimester of pregnancy has been experiencing severe morning sickness. She asks, 'I've heard that ginger tablets may be a natural way to ease the nausea and vomiting. Is it okay to try them?' What is the nurse's best response?
- A. They are a safe and natural remedy for nausea when you are pregnant.
- B. Go ahead and try them, but stop taking them once the nausea is relieved.
- C. Some health care providers do not recommend ginger during pregnancy. Let's check with your provider.
- D. You will need to wait until after the first trimester to try them.
Correct Answer: C
Rationale: There is some anecdotal evidence that ginger may have abortifacient properties, and for this reason some providers do not recommend its use during pregnancy.
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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 mother calls the pediatrician's office to report that her 18-month-old child has eaten half of a bottle of baby aspirin. She says 'I have a bottle of syrup of ipecac. Should I give it to him? He seems fine right now. What do I do?' What is the nurse's best response?
- A. Go ahead and give him the ipecac, and then call 911.
- B. Don't give him the ipecac. Call the Poison Control number immediately for instructions.
- C. Please come to the office right away so that we can check him.
- D. Go ahead and take him to the emergency room right now.
Correct Answer: B
Rationale: The American Academy of Pediatrics no longer recommends the use of syrup of ipecac for home treatment for poisoning. In all cases of poisoning, if the victim is conscious and alert, call the local poison control center. If the victim has collapsed or stopped breathing, call 911 for emergency transport to a hospital.
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.
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 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.