A school-age child diagnosed with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
Administer an antiemetic at least 30 minutes before chemotherapy begins.
Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.
Encourage drinking large amounts of favorite fluids.
Administer an antiemetic as soon as child has nausea.
The Correct Answer is A
A. Administering an antiemetic at least 30 minutes before chemotherapy begins is correct because prevention is more effective than treatment after symptoms appear. Administering antiemetics prophylactically helps reduce the severity and incidence of chemotherapy-induced nausea and vomiting, improving patient comfort and adherence to treatment.
B. Encouraging the child to remain NPO until nausea subsides is incorrect because prolonged fasting does not prevent chemotherapy-induced nausea and may contribute to dehydration and nutritional deficits, especially important in children undergoing cancer treatment.
C. Encouraging drinking large amounts of fluids is incorrect because forcing large volumes may worsen nausea or vomiting. Fluid intake should be adequate but balanced to prevent discomfort.
D. Administering an antiemetic after the child has nausea is incorrect because reactive treatment is less effective than prophylactic administration. Once severe nausea and vomiting have occurred, they are harder to control and can impact hydration, nutrition, and overall treatment tolerance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}
Explanation
- Providing choices when possible: Supports atraumatic care by giving the child a sense of control, which can reduce fear and anxiety during procedures.
- Threatening loss of privileges: Does not support atraumatic care; using threats increases fear and stress, which is counterproductive to minimizing trauma.
- Using a calm, reassuring tone: Supports atraumatic care; helps the child feel safe and understood during a stressful procedure.
- Asking the parent to leave: Does not support atraumatic care; parental presence often reduces anxiety for the child and improves coping.
Correct Answer is D
Explanation
A. Urinary tract infection is incorrect because while UTIs can cause dysuria, urgency, and sometimes hematuria, they rarely follow a strep throat infection and do not typically cause periorbital edema or tea-colored urine in otherwise healthy children.
B. Nephrotic syndrome is incorrect because nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema, rather than the hematuria, mild periorbital edema, and tea-colored urine seen here.
C. Acute tubular necrosis is incorrect because ATN is usually associated with ischemic or nephrotoxic injury and presents with oliguria and elevated creatinine, not a history of recent streptococcal infection or classic tea-colored urine.
D. Acute post-streptococcal glomerulonephritis (APSGN) is correct because APSGN typically occurs 1–2 weeks after a streptococcal pharyngitis or skin infection. Classic manifestations include periorbital edema, hematuria (tea- or cola-colored urine), mild proteinuria, decreased urine output, and hypertension. This child’s history of recent strep throat followed by these renal symptoms is highly indicative of APSGN.
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