Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
Basic Pharmacology for Nurses 17th Ed by Clayton - Willihnganz
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Chapter 33: Drugs Used to Treat Nausea and Vomiting
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Prochlorperazine (Compazine) suppository daily, on the day of treatment and the next 3 days |
| b. | Anticholinergic agents, such as diphenhydramine or meclizine |
| c. | Parenteral ondansetron 1 hour before chemotherapy, with oral ondansetron to continue for the next 4 days |
| d. | Parenteral ondansetron during chemotherapy, with prochlorperazine suppositories daily for 1 week |
ANS: C
With the patient’s first treatment history and the emetogenic chemotherapy agent, cisplatin, ondansetron has shown to be the most effective for prevention of severe nausea and vomiting. Prochlorperazine and anticholinergic agents are not used for the treatment of CINV. The ondansetron should be administered 1 hour before the chemotherapy and continued for the next several days to prevent vomiting and dehydration associated with chemotherapy administration.
DIF: Cognitive Level: Application REF: Page 514 OBJ: 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Fluid and Electrolytes
| a. | Serotonin antagonists |
| b. | Phenothiazines |
| c. | Corticosteroids |
| d. | Anticholinergics |
ANS: D
Anticholinergic agents are used to treat motion sickness by counterbalancing the excessive amounts of acetylcholine present. Serotonin antagonists are used in the treatment of emesis associated with cancer chemotherapy, radiation therapy, and postoperative nausea and vomiting. Phenothiazines are used in the treatment of mild to moderate nausea and vomiting associated with anesthesia and surgery, radiation therapy, and cancer chemotherapy. Corticosteroids are used in the treatment of nausea and vomiting related to pregnancy, postsurgical state, chemotherapy, radiation, and bowel obstruction.
DIF: Cognitive Level: Knowledge REF: Page 521 OBJ: 1 | 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Health Promotion
| a. | Prolong the effects of anesthesia |
| b. | Decrease the potential for thrombus formation |
| c. | Prevent postoperative nausea and vomiting |
| d. | Decrease postoperative pain |
ANS: C
Metoclopramide (Reglan) is an antiemetic and antagonist of dopamine and serotonin receptors. In addition to acting on receptor sites in the brain, metoclopramide increases sphincter tone in the gastrointestinal tract, which reduces nausea and vomiting. Metoclopramide does not affect anesthesia or the vascular system and does not have analgesic effects.
DIF: Cognitive Level: Comprehension REF: Page 513 OBJ: 1
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Health Promotion
| a. | Bradycardia, diarrhea, and flushing |
| b. | Pallor, sweating, and tachycardia |
| c. | Urinary urgency, chills, and dizziness |
| d. | Fever, hyperventilation, and bradycardia |
ANS: B
Autonomic symptoms of pallor, sweating, and tachycardia cause additional discomfort associated with vomiting. Bradycardia, diarrhea, flushing, urinary urgency, chills, dizziness, fever, and hyperventilation are not autonomic symptoms associated with vomiting.
DIF: Cognitive Level: Knowledge REF: Page 507 | Page 508
OBJ: N/A TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
NOT: CONCEPT(S): Clinical Judgment; Safety
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