The next 3 questions relate to this case study:
Select 4 appropriate interventions for the prevention and management of chemotherapy-induced nausea and vomiting (CINV) in Ms. Anderson.
Offer peppermint aromatherapy during and after chemotherapy.
Administer antiemetics before chemotherapy.
Keep Ms. Anderson NPO for the duration of the chemotherapy.
Encourage the patient to eat and drink when not nauseated.
Offer small sips of ginger ale.
Encourage Ms. Anderson to eat a high-protein meal prior to the chemotherapy infusion.
Correct Answer : A,B,D,E
Choice A reason:
Offering peppermint aromatherapy during and after chemotherapy can be an effective non-pharmacological intervention for managing chemotherapy-induced nausea and vomiting (CINV). Aromatherapy with peppermint oil has been shown to reduce nausea and improve comfort in patients undergoing chemotherapy. The scent of peppermint can have a calming effect on the gastrointestinal system, helping to alleviate nausea. This intervention is easy to implement and can be used alongside other treatments to enhance patient comfort.
Choice B reason:
Administering antiemetics before chemotherapy is a standard practice for preventing CINV. Antiemetics, such as 5-HT3 receptor antagonists (e.g., ondansetron), NK1 receptor antagonists (e.g., aprepitant), and corticosteroids (e.g., dexamethasone), are commonly used to prevent nausea and vomiting associated with chemotherapy. These medications are most effective when given prophylactically, before the onset of symptoms. Administering antiemetics before chemotherapy helps to block the pathways that trigger nausea and vomiting, providing better control over these symptoms.
Choice C reason:
Keeping Ms. Anderson NPO (nothing by mouth) for the duration of the chemotherapy is not recommended for managing CINV. Keeping patients NPO can lead to dehydration and malnutrition, which can worsen their overall condition. Instead, patients should be encouraged to eat small, frequent meals and stay hydrated to maintain their strength and well-being. Proper nutrition and hydration are essential for supporting the body’s ability to tolerate chemotherapy and recover from its side effects.
Choice D reason:
Encouraging the patient to eat and drink when not nauseated is an important strategy for managing CINV. Eating small, frequent meals and staying hydrated can help maintain energy levels and prevent dehydration. Patients should be advised to eat bland, easy-to-digest foods and avoid foods that are greasy, spicy, or have strong odors, as these can exacerbate nausea. Encouraging patients to eat and drink when they feel well can help them maintain their nutritional status and improve their overall tolerance to chemotherapy.
Choice E reason:
Offering small sips of ginger ale can help manage nausea. Ginger has natural antiemetic properties and can be effective in reducing nausea and vomiting. Ginger ale, ginger tea, or ginger candies can be soothing and help settle the stomach. This simple intervention can be easily incorporated into the patient’s routine and can provide relief from mild to moderate nausea.
Choice F reason:
Encouraging Ms. Anderson to eat a high-protein meal prior to the chemotherapy infusion is not typically recommended for managing CINV. High-protein meals can be harder to digest and may increase the risk of nausea. Instead, patients should be advised to eat light, bland meals before chemotherapy to minimize the risk of nausea and vomiting. Light meals are easier on the stomach and less likely to trigger gastrointestinal discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Alkalosis
Alkalosis occurs when the blood pH is higher than the normal range, specifically above 7.45. This condition indicates that the blood is too alkaline. Causes of alkalosis can include hyperventilation, loss of stomach acid through vomiting, or an overuse of diuretics. Since a blood pH of 7.21 is below the normal range, it does not indicate alkalosis.
Choice B: Normal Blood pH
The normal pH range for blood is between 7.35 and 7.45. This range is crucial for the body’s metabolic processes and enzyme functions. A blood pH of 7.21 is below this range, indicating an abnormal condition.
Choice C: Acidosis
Acidosis is the correct answer. It occurs when the blood pH drops below 7.35, indicating that the blood is too acidic. A pH of 7.21 is significantly below the normal range, confirming acidosis. This condition can result from various factors, including respiratory issues that lead to an accumulation of carbon dioxide or metabolic problems that increase acid production or decrease bicarbonate levels.
Choice D: Hyperkalemia
Hyperkalemia refers to an elevated level of potassium in the blood, not a change in blood pH. While hyperkalemia can be associated with acidosis, it is not defined by the pH level itself. Therefore, a blood pH of 7.21 does not directly indicate hyperkalemia.
Correct Answer is D
Explanation
Choice A: Peripheral pulses
Monitoring peripheral pulses is important for assessing circulation and detecting any signs of vascular complications. However, it is not the most critical assessment for a patient receiving 3% NaCl for hyponatremia. The primary concern with hypertonic saline infusion is the risk of fluid overload and central nervous system (CNS) complications.
Choice B: Urinary output
Monitoring urinary output is essential for assessing kidney function and fluid balance. While it is important, it is not the most critical assessment in this scenario. The primary risks associated with 3% NaCl infusion include rapid changes in serum sodium levels and potential CNS complications.
Choice C: Peripheral edema
Peripheral edema can indicate fluid overload, but it is not the most immediate concern when administering hypertonic saline. The nurse should prioritize monitoring for signs of pulmonary edema and neurological changes, which can occur more rapidly and have more severe consequences.
Choice D: Lung sounds and neurological status
Monitoring lung sounds and neurological status is the most important assessment for a patient receiving 3% NaCl for hyponatremia. Hypertonic saline can cause rapid shifts in fluid balance, leading to pulmonary edema and neurological complications such as osmotic demyelination syndrome. Assessing lung sounds helps detect early signs of fluid overload in the lungs, while monitoring neurological status helps identify any changes in mental status or neurological function that could indicate serious complications.
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