Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications?
Use the antiemetic after it is clear that nonpharmacologic methods are not effective
Provide the antiemetic as needed (PRN) when nausea and vomiting are reported
Administer the antiemetic before starting chemotherapy
Start the antiemetic on a scheduled basis when the chemotherapy begins to cause nausea
The Correct Answer is C
A. This is ineffective. Waiting until nausea occurs reduces the effectiveness of antiemetics because CINV is often more difficult to control once established. Nonpharmacologic methods (e.g., relaxation, acupressure) can help, but they are usually adjuncts, not first-line preventive therapy.
B. PRN administration is reactive rather than proactive. Chemotherapy often induces anticipatory or acute nausea, which may not respond fully to medication given after symptoms begin. This approach increases discomfort and the risk of dehydration and electrolyte imbalance.
C. Prophylactic administration ensures that the medication is at therapeutic levels in the bloodstream before chemotherapy begins, preventing or reducing the severity of nausea and vomiting. This approach is supported by clinical guidelines and improves patient comfort and treatment adherence.
D. Delaying scheduled dosing until nausea starts is less effective. Nausea prevention is more effective than treatment after it occurs. Scheduled dosing should begin before or at the start of chemotherapy, not after symptoms develop.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A positive Kernig’s sign (pain and resistance when attempting to extend the knee with the hip flexed) is a classic indicator of meningeal irritation, which, in the presence of fever, headache, neck stiffness, photophobia, and lethargy, strongly suggests meningitis. This finding requires immediate attention because bacterial meningitis can progress rapidly and become life-threatening.
B. While a petechial or purpuric rash may be seen in meningococcal meningitis, a general red raised rash is nonspecific and not the most urgent additional finding compared with a positive Kernig’s sign. Its absence does not rule out meningitis.
C. A negative Brudzinski’s sign (no involuntary hip/knee flexion when the neck is flexed) does not rule out meningitis, especially in early or mild cases. A positive Kernig’s sign is a more sensitive early indicator in this scenario.
D. A negative Babinski’s sign is normal and does not indicate neurological compromise in this context. Its presence or absence is not immediately relevant to the acute presentation of suspected meningitis.
Correct Answer is D
Explanation
A. Hyposecretion of somatotropin (growth hormone) results in growth retardation or short stature over time, but does not cause acute changes in urine output, sodium balance, or water retention. It is unrelated to the acute presentation described.
B. Hypersecretion of somatotropin leads to gigantism in children or acromegaly in adults. This condition affects growth and skeletal development, not fluid balance or electrolyte disturbances, so it does not explain the current findings.
C. Diabetes Insipidus (DI) involves hyposecretion or resistance to antidiuretic hormone (ADH), leading to polyuria, polydipsia, hypernatremia, and dehydration. The child’s decreased urine output and water retention are opposite of DI manifestations, so DI is inconsistent with this presentation.
D. Syndrome of inappropriate antidiuretic hormone (SIADH) involves excessive release of ADH, leading to water retention, decreased urine output (oliguria), dilutional hyponatremia, and signs of water intoxication. In the context of bacterial meningitis, SIADH is a recognized complication due to stress on the hypothalamic-pituitary axis or CNS irritation. The child’s nausea, headache, and hyponatremia fit the clinical pattern of SIADH, making it the most likely pituitary-related disorder in this scenario.
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