Nokea
The nurse is preparing to administer ondansetron to an older adult client. Which safety warning(s) should the nurse consider when administering the medication? Select all that apply.
- A. Do not use if the client has a heart block or prolonged QT interval.
- B. Increases sedation if used with opiates.
- C. Emphasize prevention. The client must take consistently to prevent nausea and vomiting.
- D. Explain that it must be started before travel to be effective.
- E. Explain that there is a risk for dehydration.
Correct Answer: A,B,C
Rationale: When administering ondansetron to an older adult client, the nurse should take extra care to consider safety warnings that advise the nurse to avoid use if a client has a heart block or prolonged QT interval, and should also be mindful that the medication can increase sedation when used with opiates. In addition, the nurse should adhere to guidelines instructing an emphasis on prevention for the client, the older adult client must take the medication consistently to prevent nausea and vomiting. Ondansetron is not given to relieve motion sickness; therefore, beginning the medication before travel is not applicable. Prochlorperazine, not ondansetron, may increase dehydration in older adults.
You may also like to solve these questions
Which assessment finding is most indicative of dumping syndrome in a postgastrectomy client?
- A. Abdominal distention, elevated temperature, weakness before eating
- B. Constipation, rectal bleeding following bowel movements
- C. Persistent loose stools, chills, hiccups after eating
- D. Weakness, diaphoresis, diarrhea 90 minutes after eating
Correct Answer: D
Rationale: Dumping syndrome produces weakness, dizziness, sweating, palpitations, abdominal cramping, and diarrhea from the rapid emptying of the chyme after eating. Elevated temperature and chills can be a significant finding for infection and should be reported. Constipation with rectal bleeding is not indicative of dumping syndrome.
The nurse is preparing to administer famotidine to a client with gastroesophageal reflux disease. Which safety warning should the nurse consider when administering the medication?
- A. Do not allow client to take maximum dose for more than 2 weeks without medical consultation.
- B. Review client's cardiac status and sodium restrictions.
- C. Do not give other oral drugs within 1 to 2 hours of administering the medication.
- D. Be aware that long-term use may be associated with bone fractures
Correct Answer: A
Rationale: The safety warning that the nurse should consider is that the client should not take the maximum dose of famotidine for more than 2 weeks without medical consultation, because it is a histamine H2 antagonist. Reviewing cardiac status and sodium restrictions is a consideration for sodium bicarbonate. Not giving oral drugs within 1 to 2 hours is a consideration for antacids. Long-term use being associated with bone fractures is a consideration for proton pump inhibitors.
A client who is recovering from bariatric surgery is returning from the postanesthesia care unit. Which nursing assessment finding is of greatest concern in the immediate postoperative period for this client?
- A. Impaired Gas Exchange
- B. Self-Care Deficit
- C. Impaired Mobility
- D. Diarrhea
Correct Answer: A
Rationale: Extremely obese clients are at greater risk for complications related to anesthesia and surgery. Obstructive sleep apnea and impaired breathing can be a problem requiring continuous or positive airway pressure devices. Self-care deficit and impaired mobility are real problems that need to be addressed but less significant than airway issues. Diarrhea due to dumping syndrome is not an immediate post-op issue.
An older adult client seeks medical attention for a report of general difficulty swallowing. Which assessment finding is most significant as related to this symptom?
- A. Hiatal hernia
- B. Gastroesophageal reflux disease
- C. Gastritis
- D. Esophageal tumor
Correct Answer: D
Rationale: The finding of an esophageal tumor is most significant and can result in advancing cancer. Esophageal cancer is a serious condition that presents with a symptom of difficulty swallowing as the tumor grows. Hiatal hernia, gastritis, and GERD can lead to serious associated complications but are less likely to be as significant as esophageal tumor/cancer.
The nurse is holding a teaching workshop on managing the symptoms of hiatal hernia in older adults. Which lifestyle modification should be included in the presentation?
- A. Eliminating tobacco use
- B. Aerobic exercising
- C. Avoiding excess stress
- D. Providing adequate rest
Correct Answer: A
Rationale: Approximately 60% of people older than 70 years of age will develop hiatal hernias. Because tobacco use reduces esophageal sphincter tone, which can result in reflux, tobacco should be avoided. Aerobic exercising, managing stress, and providing adequate rest are good for general health not specific to the management of hiatal hernias.