A nurse is providing teaching to a client who is scheduled to receive chemotherapy and has a prescription for ondansetron to control nausea and vomiting.
Which of the following information should the nurse include in the teaching?
Restlessness is an expected adverse effect of the medication.
Take the medication 30 minutes after chemotherapy.
Acute nausea resolves within 12 hours of chemotherapy administration.
Additional medications can be required if nausea persists.
The Correct Answer is D
Choice A rationale
Restlessness, also known as akathisia, is not a typical expected adverse effect of ondansetron. Ondansetron primarily acts as a selective 5-HT3 receptor antagonist, blocking serotonin's emetogenic effects in the chemoreceptor trigger zone and gastrointestinal tract. Common adverse effects are generally mild, including headache, constipation, or diarrhea, with neurological effects like restlessness being rare and atypical for this drug's primary mechanism.
Choice B rationale
Ondansetron should be administered prophylactically, typically 30 minutes *before* chemotherapy, to achieve optimal antiemetic effect. Its mechanism involves blocking serotonin receptors that, when activated by chemotherapy, trigger nausea and vomiting. Pre-emptive administration ensures therapeutic drug levels are present to counteract the emetogenic stimuli effectively before their onset.
Choice C rationale
Acute nausea and vomiting associated with chemotherapy can persist for significantly longer than 12 hours, often lasting for 24 to 48 hours or even longer depending on the specific chemotherapeutic agent and its emetogenic potential. The duration of emesis is highly variable and directly related to the drug's pharmacokinetic profile and the extent of serotonin release.
Choice D rationale
If nausea persists despite ondansetron administration, it indicates an inadequate antiemetic response, likely due to the complex neurochemical pathways involved in chemotherapy-induced nausea and vomiting. This often necessitates a multi-modal approach, involving the addition of other antiemetic agents like corticosteroids (e.g., dexamethasone) or neurokinin-1 receptor antagonists (e.g., aprepitant) to target different emetogenic pathways for more complete symptom control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Tuberculosis is a bacterial infection primarily affecting the lungs, caused by *Mycobacterium tuberculosis*. Didanosine is an antiretroviral medication, specifically a nucleoside reverse transcriptase inhibitor (NRTI), and as such, it does not possess antimicrobial activity against bacterial pathogens like *Mycobacterium tuberculosis*. Therefore, it is not indicated for treating tuberculosis.
Choice B rationale
Human immunodeficiency virus (HIV) is a retrovirus that attacks the body's immune system. Didanosine is an antiretroviral drug that inhibits the replication of HIV by interfering with the reverse transcriptase enzyme, which is crucial for the virus to convert its RNA into DNA. This mechanism of action effectively reduces the viral load and improves immune function in individuals with HIV infection.
Choice C rationale
Bacterial meningitis is an inflammation of the meninges, the membranes surrounding the brain and spinal cord, caused by various bacterial species. Didanosine is an antiviral agent specifically targeting retroviruses like HIV. It does not have any direct antibacterial properties or efficacy against the common bacterial pathogens responsible for meningitis, thus making it an inappropriate treatment.
Choice D rationale
Syphilis is a sexually transmitted infection caused by the bacterium *Treponema pallidum*. The primary treatment for syphilis is antibiotics, particularly penicillin. Didanosine, being an antiretroviral medication, does not exhibit any treponemicidal activity and is ineffective against *Treponema pallidum*. Therefore, it is not used in the treatment of syphilis.
Correct Answer is D
Explanation
Choice A rationale
Magnesium levels within the normal range (1.3 to 2.1 mEq/L) are important for overall electrolyte balance, but sodium polystyrene sulfonate specifically targets potassium. While hyperkalemia can sometimes be associated with other electrolyte imbalances, a normal magnesium level does not directly indicate a therapeutic response to sodium polystyrene sulfonate, as its primary action is not on magnesium.
Choice B rationale
Calcium levels within the normal range (9 to 10.5 mg/dL) are essential for various physiological functions. Sodium polystyrene sulfonate primarily exchanges sodium ions for potassium ions, not calcium. Therefore, a normal calcium level does not reflect a therapeutic response to the medication, which is specifically aimed at reducing elevated potassium levels.
Choice C rationale
Sodium levels within the normal range (136 to 145 mEq/L) are crucial for fluid balance and neurological function. Sodium polystyrene sulfonate exchanges sodium for potassium, meaning it increases the body's sodium load. While a normal sodium level is desirable, it does not directly indicate the therapeutic efficacy of the medication in reducing potassium.
Choice D rationale
Potassium 4.8 mEq/L (3.5 to 5 mEq/L) indicates a therapeutic response. Sodium polystyrene sulfonate is an ion-exchange resin used to treat hyperkalemia by exchanging potassium ions for sodium ions in the gastrointestinal tract. A potassium level returning to within the normal range, from a previously elevated state, signifies that the medication has effectively lowered the excess potassium.
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