A nurse caring for a patient who is undergoing a third round of ...

[Davideckstein7]

A nurse caring for a patient who is undergoing a third round of chemotherapy is preparing to administer ondansetron (Zofran) 30 minutes before initiation of the chemotherapy.
 
  The patient tells the nurse that the ondansetron did not work as well the last time as it had the first time. What will the nurse do?
  a. Administer the ondansetron at the same time as the chemotherapy.
  b. Contact the provider to suggest using high-dose intravenous dolasetron (Anzemet).
  c. Request an order to administer dexamethasone with the ondansetron.
  d. Suggest to the provider that loperamide (Lomotil) be given with the ondansetron.

Question 2

A patient has been taking senna (Senokot) for several days, and the nurse notes that the urine is yellowish-brown. What does the nurse know about this symptom?
 
  a. It indicates that renal failure has occurred.
  b. It is caused by dehydration, which is a laxative side effect.
  c. It is a sign of toxicity, indicating immediate withdrawal of the drug.
  d. It is an expected, harmless effect of senna.

[Ahnyah]

Answer to Question 1

ANS: C
Ondansetron is a serotonin receptor antagonist; drugs in this class are the most effective drugs available for suppressing nausea and vomiting associated with anticancer drugs. The drug is even more effective when combined with dexamethasone. For best effect, ondansetron should be given 30 minutes before beginning chemotherapy. Dolasetron is similar to ondansetron, but when given intravenously in high doses, it is associated with fatal dysrhythmias. Loperamide is used to treat diarrhea.

Answer to Question 2

ANS: D
Systemic absorption of senna, followed by renal excretion, may impart a harmless yellowish-brown or pink color to the urine. This symptom is not an indication of renal failure, dehydration, or toxicity.