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 D
Explanation
Choice A rationale
Androgen therapy can lead to fluid retention, which would typically cause weight gain rather than weight loss. Androgens promote anabolism and can increase muscle mass and erythrocyte production, but they also influence fluid balance by affecting renal sodium and water reabsorption.
Choice B rationale
Androgen therapy generally does not cause hypotension. In some cases, it may lead to a slight increase in blood pressure due to fluid retention and effects on the renin-angiotensin-aldosterone system. Hypotension is not a recognized common adverse effect of androgen therapy.
Choice C rationale
Androgen therapy does promote muscle hypertrophy due to its anabolic effects, increasing protein synthesis and muscle mass. However, this is generally a desired therapeutic effect, not an adverse effect requiring monitoring for cessation, especially when used for conditions like muscle wasting.
Choice D rationale
Androgens can cause fluid retention, leading to edema. This occurs due to their influence on mineralocorticoid receptors in the renal tubules, which promotes sodium and water reabsorption. Nurses should monitor for signs of fluid overload, such as peripheral or pulmonary edema, and changes in body weight.
Correct Answer is C
Explanation
Choice A rationale
Blood glucose monitoring accuracy is generally not directly affected by hydrochlorothiazide. The medication's impact is on glucose metabolism itself, not the accuracy of the measurement device. Hydrochlorothiazide affects the pancreatic beta cells or peripheral insulin sensitivity, leading to altered glucose homeostasis, not erroneous readings from a glucometer.
Choice B rationale
Decreasing insulin dosage is generally not appropriate when taking hydrochlorothiazide. Hydrochlorothiazide, a thiazide diuretic, can induce hyperglycemia by impairing insulin secretion from the pancreatic beta cells or by reducing peripheral glucose utilization, thereby requiring an *increase* in insulin dosage to maintain glycemic control, not a decrease.
Choice C rationale
Hydrochlorothiazide therapy can elevate blood glucose levels in clients who have diabetes. This effect is attributed to the medication's ability to impair insulin secretion from pancreatic beta cells or to decrease peripheral glucose utilization, leading to insulin resistance. This necessitates careful blood glucose monitoring (normal fasting glucose <100 mg/dL).
Choice D rationale
Reducing sodium in the diet while taking hydrochlorothiazide is beneficial for blood pressure control by augmenting the diuretic's effects, but it does not directly control blood glucose levels. While a healthy diet supports overall health, the primary mechanism of glucose elevation from hydrochlorothiazide is metabolic, not sodium-related.
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