Antiemetics

Every question here, with the answer

1. A nurse is applying a scopolamine patch for a client who gets motion sickness. Which action is correct?

   1. Apply it just as the client boards the boat.
   2. Apply it to the chest without gloves so it sticks better.
   3. Apply it to the hairless area behind the ear while wearing gloves.
   4. Cut the patch in half to reduce the dose.

   Answer: Apply it to the hairless area behind the ear while wearing gloves.

   The patch goes on the clean, dry, hairless area behind the ear, and the nurse wears gloves to avoid cross-absorption. It is applied about 4 hours before travel, not at departure.

2. A parent asks whether promethazine can be given to an 18-month-old with vomiting. What should the nurse recognise?

   1. It is only unsafe in older adults.
   2. It is safe if given rectally.
   3. It is safe at a reduced dose.
   4. It carries a warning of severe respiratory depression and death in children under age 2.

   Answer: It carries a warning of severe respiratory depression and death in children under age 2.

   The black box warning states that severe respiratory depression and death may occur with promethazine in pediatric clients under age 2. No dose or route change makes it safe for this child.

3. A client receiving chlorpromazine develops involuntary facial movements and muscle spasms of the neck. What should the nurse do?

   1. Document it as an expected effect.
   2. Give the next dose early.
   3. Encourage the client to exercise the neck.
   4. Report it to the health care provider immediately.

   Answer: Report it to the health care provider immediately.

   Chlorpromazine can cause extrapyramidal symptoms such as dystonia and tardive dyskinesia, and the nurse reports these to the health care provider immediately. They are not expected side effects to simply document or to treat with more drug.

4. A client is receiving prochlorperazine for nausea. Which nursing actions are appropriate? Select all that apply.

   1. Initiate fall precautions.
   2. Monitor intake and output for urinary retention.
   3. Tell the client it is safe to drive right after the dose.
   4. Encourage the client to drink alcohol to relax.
   5. Monitor blood pressure for hypotension.

   Answer: Initiate fall precautions., Monitor intake and output for urinary retention., Monitor blood pressure for hypotension.

   Antiemetics can cause orthostatic hypotension, dizziness and urinary retention, so the nurse initiates fall precautions and monitors blood pressure and output. Alcohol adds CNS depression, and clients should not drive because of drowsiness.

5. The nurse is teaching a client going home with an antiemetic. Which instructions should be included? Select all that apply.

   1. Increase fiber and fluids if not contraindicated.
   2. Use sugarless candy or gum for dry mouth.
   3. Stop drinking fluids to reduce nausea.
   4. Rise slowly from lying or sitting.
   5. Take the drug with a sleeping pill to improve rest.

   Answer: Increase fiber and fluids if not contraindicated., Use sugarless candy or gum for dry mouth., Rise slowly from lying or sitting.

   Teaching covers dry mouth relief, fiber and fluids to prevent constipation, and rising slowly because of orthostatic hypotension. Combining with other CNS depressants increases sedation and respiratory depression, and fluids should be increased, not stopped.

6. An older adult with dementia-related psychosis has an order for prochlorperazine for nausea. What should concern the nurse?

   1. Risk of hyperglycemia
   2. Increased mortality in this population
   3. Risk of weight gain
   4. Loss of effect after one dose

   Answer: Increased mortality in this population

   The black box warning states increased mortality can occur with chlorpromazine and prochlorperazine in older adults with dementia-related psychosis. The other options are not warnings given for these drugs.