Lilley Chapter 41 - Antiemetic and Antinausea Flashcards
Metoclopramide is useful in treating postoperative nausea and vomiting because of which of the following actions?
It inhibits chemoreceptor stimulation.
It decreases peristalsis in the intestinal wall.
It promotes motility in the small intestine.
It improves the body’s response to analgesia.
C. It promotes motility in the small intestine.
Metoclopramide works by increasing gastrointestinal (GI) motility in the small intestine, thus minimizing gastric distention and the accompanying stimulation of the vomiting center.
When planning administration of antiemetic medications to a patient, the nurse is aware that combination therapy is preferred because
the risk of constipation is decreased.
drug absorption and distribution are faster.
the desired level of sedation is achieved more easily.
different vomiting pathways are blocked.
D. different vomiting pathways are blocked.
Combining antiemetic drugs from various categories allows the blocking of the vomiting centre and chemoreceptor trigger zone (CTZ) through different pathways, thus enhancing the antiemetic effect.
In developing a plan of care for a patient receiving an antihistamine antiemetic drug, which nursing diagnosis would be the highest priority nursing diagnosis?
Risk for injury related to adverse effects of medication
Deficient knowledge regarding medication administration
Deficient fluid volume related to nausea and vomiting
Impaired physical mobility related to adverse effects of drugs
C. Deficient fluid volume related to nausea and vomiting
Although all of the options are appropriate nursing diagnoses, fluid volume deficit is the highest priority because it has the highest associated mortality rate. Although a fall or injury could also prove fatal, that diagnosis is a risk; actual nursing diagnoses have priority over potential diagnoses.
A patient receiving an anticholinergic drug to treat nausea and vomiting should be taught to expect which adverse effect?
Bradycardia
Dry mouth
Diarrhea
Lacrimation
B.Dry mouth
Anticholinergic drugs block the parasympathetic nervous system, which causes the body to “rest and digest.” Blocking of these effects leads to constipation, urinary retention, and decreased secretions (dry mouth).
Which drug works by blocking serotonin receptors in the GI tract, vomiting center, and CTZ?
meclizine
ondansetron (Zofran®)
metoclopramide
droperidol
B. ondansetron (Zofran®)
Ondansetron is a serotonin blocker. Metoclopramide is a prokinetic drug, meclizine is an antihistamine, and droperidol is an antidopaminergic drug.
Before administering the anticholinergic drug scopolamine, the nurse should carefully assess the patient for a history of which condition?
Gastroenteritis
Glaucoma
Rheumatoid arthritis
Hyperthyroidism
B. Glaucoma
Anticholinergic drugs are contraindicated in patients with glaucoma. These drugs can cause pupillary dilation, which can obstruct the flow of aqueous humour and increase intraocular pressure.
The nurse plans to administer 50 mg of diphenhydramine (Benadryl®) intravenously. How will the nurse administer this medication?
Undiluted over 1 minute
Undiluted over 2 minutes
Diluted in 50 mL of normal saline over 30 minutes
Diluted in 100 mL D5W over 20 minutes
B. Undiluted over 2 minutes
Diphenhydramine should be administered undiluted at a rate of 25 mg/min.
The nurse should teach a patient about which antiemetic commonly used to prevent motion sickness?
scopolamine
prochlorperazine
droperidol
metoclopramide
A. scopolamine
Scopolamine has potent effects on the vestibular nuclei, which are located in the area of the brain that controls balance. These effects make scopolamine one of the most commonly used drugs for the treatment and prevention of nausea and vomiting associated with motion sickness.
Which of the following directions applies to the administration of metoclopramide?
Give 30 minutes before meals and at bedtime.
Give with a full glass of water in the morning.
Give with food to decrease GI upset.
Give with 240 mL of orange or apple juice.
A. Give 30 minutes before meals and at bedtime.
Metoclopramide should be administered 30 minutes before meals and at bedtime. Administering the medication before meals allows time for onset to increase GI motility before food ingestion, thus decreasing stomach distention and resulting nausea and vomiting.
Which patient statement indicates the need for further teaching about antiemetic medications?
“I will apply the scopolamine patch to my right or left arm and rotate the sites of application.”
“I should take my prescribed antiemetic before receiving my chemotherapy dose.”
“I may take Tylenol to treat the headache caused by ondansetron.”
“I will not drive while I am taking these medications, because they may cause drowsiness.”
A. “I will apply the scopolamine patch to my right or left arm and rotate the sites of application.”
Transdermal scopolamine patches should be applied to nonirritated areas behind the ear, not on the arms.
