Chapter 24-agents used to treat antiemetics & emetics

Question 1

The nurse understands that which of the following clients would be the most likely to misuse the drug ipecac?

Answer 1

an adolescent with bulimia

Question 2

A client is being seen by the health care provider for a prescription medication for motion sickness. The nurse anticipates the client will be prescribed:

Answer 2

meclizine.-is an antihistamine used to treat motion sickness.

Question 3

A pregnant client is admitted with excessive nausea and vomiting. Proactively, the nurse will place the client in what position?

Answer 3

side lying-This is the position of choice to prevent aspiration.

Question 4

A client is receiving antiemetic therapy for a history of frequent nausea and vomiting. In caring for this client the nurse should:

Answer 4

monitor for fluid and electrolyte imbalances.

Question 5

Prescribed is ondansetron 4 mg IV for a client with a central venous access. The pharmacy provides ondansetron 4 mg in 50 mL of D5W to infuse over 15 minutes. The nurse will program the volumetric infusion pump at:

Answer 5

200 mL/hr-Cross multiply X/60 min = 50 mL/15 min, which = 15X = 3,000. Divide 3,000 by 15 = 200 mL/hr, which can be administered at that rate through a CVAD (central venous access device).

Question 6

The nurse should question administering promethazine to a client with a history of:

Answer 6

benign prostatic hypertrophy (BPH).

Promethazine can aggravate urinary retention associated with BPH.

Question 7

A client is receiving chlorpromazine HCl. The nurse understands that this medication is classified as a/an:

Answer 7

neuroleptic.

Question 8

A client receiving emetogenic chemotherapy should receive which of the following medications as a premedication?

Answer 8

ondansetron-This is the most common serotonin-blocking agent used as a premed for chemotherapy.

Question 9

The nurse is aware of a special warning on the label of droperidol about the risk of:

Answer 9

sudden cardiac death

Question 10

A client on chemotherapy asks the nurse why he is now prescribed aprepitant as one of his premeds. The nurse’s best response is:

Answer 10

“This drug is combined with your other premeds for better control of nausea.”

Question 11

A client is receiving a serotonin antagonist and a corticosteroid as premedications for chemotherapy. The nurse understands these agents are used in this circumstance to:

Answer 11

prevent acute and delayed nausea and vomiting caused by chemotherapy.

Question 12

A postoperative client is prescribed IV promethazine to treat his nausea. The nurse understands that this agent:

Answer 12

is not compatible with lactated Ringer’s IV solution.
: It precipitates in IV tubing containing lactated Ringer’s solution, a common postoperative solution infused in PACU (post anesthesia care unit).

Question 13

A client is prescribed IV palonosetron HCl. The nurse understands the action of this agent is to:

Answer 13

prevent delayed nausea and vomiting related to chemotherapy.
This drug’s benefit over the other serotonin antagonists is that it has a longer half-life, making it effective in treating chemo-induced delayed nausea and vomiting.

Question 14

When planning care for a client receiving treatment for vomiting, the nurse’s highest priority nursing diagnosis is:

Answer 14

risk for aspiration related to vomiting.

Question 15

Prior to administering IV palonosetron, the nurse should:

Answer 15

flush the IV line with 0.9% saline.

Question 16

The nurse is caring for a client with urinary retention secondary to benign prostatic hypertrophy (BPH) experiencing nausea. The nurse would question which of the following prescriptions written by the health care provider for this client?

Answer 16

promethazine 25 mg IV now

Question 17

A client receiving chemotherapy is prescribed dolasetron mesylate 100 mg IV. The nurse plans to administer the dolasetron mesylate:

Answer 17

30 minutes prior to chemotherapy.

Serotonin antagonists should be administered 30 minutes prior to chemo.

Question 18

Ondansetron IV is prescribed for a client. The recommended safe dose for IV ondansetron is 0.15 mg/kg/dose. What is the safe dose for a client who weighs 132 pounds?

Answer 18

9 mg- 132 pounds divided by 2.2 = 60 kg; multiplied by 0.15 mg = 9 mg/dose

Question 19

A child weighing 21 pounds is prescribed diphenhydramine by mouth to prevent nausea associated with receiving immunizations. The recommended safe dose for diphenhydramine is 5 mg/kg/day in four divided doses. This child’s individual dose should not exceed:

Answer 19

12 mg/dose-21 pounds divided by 2.2 = 9.54 kg; multiplied by 5 = 47.7 mg/day; divided by 4 doses = 11.9 mg, which rounds to 12 mg/dose.

Question 20

When teaching mothers of infants and small children about vomiting and diarrhea in their children, which statement by one of the mothers indicates an understanding of the teaching?

Answer 20

“I will take him to the pediatrician if his vomiting lasts more than 24 hours.”

Infants and children should be seen by a health care provider if vomiting or diarrhea lasts for 24 hours.

Question 21

The nurse is caring for a client who is to receive chemotherapy. When the nurse notes the client does not have a prescription for premedication prior to chemotherapy, he or she should:

Answer 21

collaborate with the health care provider for a premedication prescription.

Question 22

The client receiving a neuroleptic agent for nausea should be instructed to:

Answer 22

rise slowly from a reclined or sitting position.

The agents can cause orthostatic hypotension

Question 23

The nurse’s priority focus when a client begins to vomit is to:

Answer 23

maintain a patent airway.

Question 24

Promethazine should not be used with children under 2 years of age, because of the risk of:

Answer 24

respiratory depression

For children under 2 years of age, respiratory depression is a severe adverse effect related to promethazine.

Question 25

The client is taking chlorpromazine HCl. Which of the following is NOT an adverse effect?

Answer 25

anorexia- Increased appetite, not anorexia, is an adverse effect of chlorpromazine HCl.

Question 26

The nurse recruit would be correct when stating a client with which of the following conditions would be most likely to misuse ipecac?

Answer 26

“bulimia”

Question 27

Which of the following statements by the nurse recruit exhibits a lack of understanding concerning activated charcoal?

Answer 27

“It is usually administered before gastric lavage.”

Question 28

For the client receiving droperidol, the nurse should monitor for which of the following? Select all that apply.

Answer 28

a. orthostatic hypotension
b. sedation
d. tardive dyskinesia
e. cardiac rhythm changes

Question 29

Which of the following statements by the nurse recruit indicates understanding of the medication, scopalamine?

Answer 29

a. “It is used to prevent nausea and vomiting associated with recovery from anesthesia.”
c. “It is used with caution in infants and children.”
e. “It can cause worsening of schizophrenia.”

Question 30

Nursing implications for phenothiazines include which of the following? Select all that apply.

Answer 30

a. protect client from fall
b. avoid noxious stimuli
c. monitor for adverse effects
d. monitor for effectiveness
f. take a thorough medication history to prevent drug interactions