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Chapter 52: Anti-Emetic Test, Antiemetic Test – Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Anti-Emetic Test, Hydroxyzine (Vistaril), Nurse, Antiemetic Test, Nausea, Pharmacology for Nurses: Practical Applications

The nurse is reviewing new postoperative orders and notes that the order reads, “Give hydroxyzine (Vistaril) 50 mg IV PRN nausea or vomiting.” The patient states that he has slight nausea. Which action by the nurse is correct at this time?

Give the patient the IV dose of hydroxyzine as ordered.

Hold the dose until the patient states that the nausea is severe.

Give the dose orally instead of intravenously.

Call the prescriber to question the route that is ordered.

The nurse needs to question the route. Hydroxyzine (Vistaril) is an antihistamine-class antiemetic that is only to be given either by oral or intramuscular routes. It may be easy to make the mistake of giving hydroxyzine intravenously because many other antiemetics are given by that route. It is important to note that intravenous, intra-arterial, or subcutaneous administration of hydroxyzine may result in significant tissue damage, thrombosis, and gangrene. The nurse cannot change the route of an ordered medication without a prescriber’s order. Antiemetic drugs are best given before the patient’s nausea become severe.

A patient is taking chemotherapy with a drug that has a high potential for causing nausea and vomiting. The nurse is preparing to administer an antiemetic drug. Which class of antiemetic drugs is most commonly used to prevent nausea and vomiting for patients receiving chemotherapy?

Prokinetic drugs, such as metoclopramide (Reglan)

Neuroleptic drugs, such as promethazine (Phenergan)

Serotonin blockers, such as ondansetron (Zofran)

Anticholinergic drugs, such as scopolamine

Serotonin blockers are used to prevent chemotherapy-induced and postoperative nausea and vomiting. The other options are incorrect. Antiemetic Test

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?

It is safe to take the medication with a glass of wine in the evening to help settle the stomach.

The patient will need to avoid driving because of possible drowsiness.

The patient may experience occasional problems with taste.

The patient may skip doses if the patient is feeling well.

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.

An adult patient is about to receive intravenous (IV) ondansetron (Zofran) during a chemotherapy treatment. A dose of 0.15 mg/kg IV 30 minutes before chemotherapy is ordered. The patient weighs 140 pounds. The medication is supplied in a vial marked 2 mg/mL for IV administration. Identify how many milliliters the nurse will administer for this dose. (record answer to one decimal place) __

Correct Answer

4.8 mL

Convert pounds to kilograms: 140 ÷ 2.2 = 63.6 kg.
Calculate milligrams per dose: 0.15 mg/kg × 63.6 kg = 9.54 = 9.5 mg/dose.
Calculate milliliters to be given:
mg:1 mL :: 9.5 mg:x mL.
(2 × x) = (1 × 9.5); 2x = 9.5; x = 4.75, which rounds to 4.8 mL.

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.)

Administering antinausea drugs 30 to 60 minutes before chemotherapy is started

Instructing the patient that the antinausea drugs may cause extreme drowsiness

Giving antinausea drugs at the beginning of the chemotherapy infusion

Observing carefully for the adverse effects of restlessness and anxiety

For best therapeutic effects, medicating for nausea once the symptoms begin

Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotension

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.