Phenothiazines are usually ineffective when nausea vomiting are caused by Quizlet

Response:

Prochlorperazine (Stemetil) is the antiemetic of choice for nausea and vomiting after anaesthesia.

Prochlorperazine is a dopamine (D2) receptor antagonist that belongs to the phenothiazine class of antipsychotic agents but is used for the treat nausea because it blocks the D2 receptors in the Chemoreceptor Trigger Zone (CTZ).

Interestingly, many pharmacological treatments which are effective for nausea and vomiting in some medical conditions may not be effective for motion sickness. For example, prochlorperazine, although widely used for nausea, is ineffective for motion-sickness prevention and treatment.

Sedating anti-histamine medications such as dimenhydrinate work quite well for motion sickness, although they can cause significant drowsiness. (Some newer anti-histamines have been specially designed not to break the blood brain barrier so that they do not cause drowsiness. Those are not effective for motion sickness).

Avoid escape of solution along the route

Trimethobenzamide may cause burning, stinging, and pain on injection. Injectable trimethobenzamide contains benzocaine and should not be used in patients allergic to benzocaine or local anesthetics. Injectable trimethobenzamide may cause skin irritation and the nurse should avoid the escape of solution along the route. Trimethobenzamide should be administered in the upper, outer quadrant of the gluteal region. Naloxone is the antidote for narcotic analgesics. Trimethobenzamide is a dopamine antagonist. Trimethobenzamide does not suppress the cough reflex.

Monitor for burning on injection of the medication

Trimethobenzamide may cause burning, stinging, and pain on injection. Injectable trimethobenzamide contains benzocaine and should not be used in patients allergic to benzocaine or local anesthetics. Injectable trimethobenzamide may cause skin irritation and the nurse should avoid the escape of solution along the route. Trimethobenzamide should be administered in the upper, outer quadrant of the gluteal region. Naloxone is the antidote for narcotic analgesics. Trimethobenzamide is a dopamine antagonist. Trimethobenzamide does not suppress the cough reflex.

Do not administer if the patient is allergic to local anesthetics

Trimethobenzamide may cause burning, stinging, and pain on injection. Injectable trimethobenzamide contains benzocaine and should not be used in patients allergic to benzocaine or local anesthetics. Injectable trimethobenzamide may cause skin irritation and the nurse should avoid the escape of solution along the route. Trimethobenzamide should be administered in the upper, outer quadrant of the gluteal region. Naloxone is the antidote for narcotic analgesics. Trimethobenzamide is a dopamine antagonist. Trimethobenzamide does not suppress the cough reflex.

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chs 57, 58, & 59

Terms in this set (20)

The nurse should be cautious in administering cimetidine in the client with which condition?

Hepatic disease and impaired renal function

Explanation:
No contraindications exist, but the use of cimetidine should be used cautiously in clients with impaired hepatic and renal function. The client with cancer, hypertension, and diabetes mellitus can take cimetidine safely.

Maalox is contraindicated in clients with:

renal dysfunction

Explanation:
Magnesium-based antacids are contraindicated in clients with renal failure. Magnesium-based antacids are not contraindicated with hypertension, regular heart rate, or stress ulcer.

The nurse instructs the client with diarrhea to return to the clinic if they continue to experience abdominal pain and fever for how many days?

2 days, or if stools contain blood or mucus.

Explanation:
Clients should consult a health care provider if diarrhea is accompanied by severe abdominal pain or fever, lasts longer than 2 days, or if stools contain blood or mucus.

In which of the following would the nurse question an order for ondansetron (Zofran)?

Treatment of gastroesophageal reflux because the mechanism of action of ondansetron does not act directly on the gastrointestinal system as other antiemetics do

Explanation:
Because the mechanism of action of ondansetron (Zofran) does not act directly on the gastrointestinal system as other antiemetics do, the nurse should question this order as a treatment for gastroesophageal reflux.

The nurse knows using bismuth subsalicylate will be a safe and effective treatment for diarrhea unless the patient has:

Allergy to aspirin

Explanation:
People with an allergy to aspirin or aspirin products should not take bismuth subsalicylate.

What should the nurse assess prior to administering a laxative?

Review of the client's chart for the course of treatment, and discovering the reason for administration of the prescribed drug. Question the client regarding the type and intensity of symptoms to provide a baseline for evaluation of the effectiveness of drug therapy. Listen first to bowel sounds and then palpate the abdomen, monitoring the client for signs of guarding or discomfort

Explanation:
It is important to assess the client before giving any medication. Important assessments include a review of the client's chart for the course of treatment, and discovering the reason for administration of the prescribed drug. Question the client regarding the type and intensity of symptoms (e.g., pain, discomfort, diarrhea, or constipation) to provide a baseline for evaluation of the effectiveness of drug therapy. Listen first to bowel sounds and then palpate the abdomen, monitoring the client for signs of guarding or discomfort. An abdominal circumference measurement and the presence of visitors are not critical assessments prior to administration of the medication

The client reports that he has been experiencing occasional constipation despite being active, having a good diet, and drinking adequate fluid. What would the nurse antic

A bulk-forming (fiber) laxative for occasional relief of constipation

Explanation:
Bulk-forming (fiber) laxatives are considered the safest and most physiologic of the laxatives. As such, they are normally preferable to stimulant and hyperosmotic laxatives for occasional relief of constipation. Bismuth subsalicylate does not relieve constipation

What is the priority nursing intervention for an older adult receiving dimenhydrinate?

Protect from injury because of drowsiness

Explanation:
Dimenhydrinate causes drowsiness, especially in older adults, and therefore should be used cautiously. The nurse should protect the client from injury. There is no indication that fluids should be forced. The client will not require IV access unless fluid replacement is prescribed

What would the nurse identify as the least common adverse effect of omeprazole?

Alopecia

Explanation:
Alopecia can occur with proton pump therapy, but it is not a common adverse effect. Common adverse effects include dizziness, headache, and cough.

What is the action of bulk stimulants on the GI tract?

increase the fluid in the intestinal contents, which enlarges bulk and stimulates local stretch receptor and activates local activity

Explanation:
Bulk laxatives increase the fluid in the intestinal contents, which enlarges bulk and stimulates local stretch receptor and activates local activity. Chemical stimulant laxatives directly stimulate the nerve plexus in the intestinal wall. Mineral oil, a lubricant, forms a slippery coat on the contents of the intestinal tract. Methylnaltrexone acts as a selective antagonist to opioid binding at the mu receptor.

=Which adverse effect would the nurse monitor for in a client taking a stimulant cathartic?

diarrhea

Explanation:
The stimulant cathartics are the strongest and most abused laxative products. These drugs act by irritating the GI mucosa and pulling water into the bowel lumen. As a result, feces are moved through the bowel too rapidly to allow colonic absorption of fecal water, so a watery stool is eliminated. Nausea, vomiting, and rectal bleeding should not routinely occur.

What should the nurse instruct the client taking omeprazole?

Swallow the tablet whole with a large glass of water. Antacids are taken 1 hour before or 2 hours after the omeprazole

Explanation:
The medication should be swallowed whole with a large glass of water. It should not be chewed, crushed, or opened. Antacids, if prescribed, should be taken 1 hour before or 2 hours after the omeprazole.

What is the antiemetic the nurse would anticipate being ordered for a 9-year-old client?

Promethazine administered oral, rectal, and parenteral

Explanation:
Promethazine is often the drug of choice with children, and it has established oral, rectal, and parenteral doses.

How does diphenoxylate with atropine sulfate resolve diarrhea?

Decreasing intestinal motility

Explanation:
Diphenoxylate with atropine sulfate resolves diarrhea by decreasing intestinal motility.

Phenothiazines are usually ineffective when nausea/vomiting are caused by:

Motion sickness

Explanation:
Phenothiazines are usually effective in preventing or treating nausea and vomiting induced by drugs, radiation therapy, surgery, and most other stimuli, but are usually ineffective in motion sickness.

Which intervention should the nurse perform in the elderly client receiving cimetidine?

Monitor the patient for confusion and dizziness

Explanation:
The nurse should closely monitor the elderly patient who has been administered cimetidine for confusion and dizziness. When the patient is receiving an antiemetic, the nurse monitors the patient frequently for continued reports of pain, sour taste, spitting blood, or coffee-ground-colored emesis. When antacids are given to the patient, the nurse should observe the patient for concentrated urine and restlessness. When the patient is administered prolonged doses of metoclopramide, the nurse reports any sign of tardive dyskinesia or extrapyramidal symptoms to the PHCP.

The nurse is aware that promethazine is contraindicated for children under 2 years of age due to:

fatal respiratory depression w/lowest effective dose because high dose can cause hallucinations, convulsions, and sudden death

Explanation:
A black box warning alerts nurses that promethazine is contraindicated in children younger than 2 years of age because of the risk of potentially fatal respiratory depression. When using promethazine, the lowest effective dosage should be used, and other drugs with respiratory depressant effects should not be given concurrently. Excessive doses may cause hallucinations, convulsions, and sudden death.

What risk is decreased when using ranitidine over cimetidine?

Drug-to-drug interaction

Explanation:
Ranitidine causes fewer drug interactions than cimetidine. Ranitidine possesses the following adverse effects: headache, diarrhea, and bradycardia.

What should the nurse assess prior to administering bismuth subsalicylate?

asses for aspirin allergy

Explanation:
Bismuth salts have antibacterial and antiviral activity. Bismuth subsalicylate contains salicylate, and the client should be assessed for an aspirin allergy before administration. It is important to assess for pain and electrolyte balance, but is not the primary assessment to be made. The nurse would not need to assess for allergy to opioids because bismuth does not contain opioids.

Which antibiotic would the nurse anticipate would be ordered for the client with Helicobacter pylori infection?

Omeprazole & other proton pump inhibitors

Explanation:
Proton pump inhibitors such as omeprazole are used as part of combination therapy with antibiotics for treatment of Helicobacter pylori infection.

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What is the therapeutic action of the phenothiazines in reducing nausea?

Which medications are related to phenothiazines or antihistamine and are ordered to control nausea and vomiting?

Which of the following drug classifications prevents nausea and vomiting?

What are drugs that inhibit vomiting called?