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Now for our nausea medications, we have Ondanzatron, brand name is Zofran, given for nausea and vomiting. And it works by blocking serotonin receptors to decrease the nausea. So the big key point here is that it can cause serotonin syndrome, which is a high risk for injury. Now a big side effect is headache and dizziness.
And according to the HESI, a priority side effect is torsades de puentes. Basically a really deadly heart rhythm. But to be honest, that was the only question in all the quiz banks that ever touched on this side effect. Now a big key point, we give it b...
before going to chemo, and before or with pain medications, which can cause nausea. Guys, we don't want to play catch-up. So the ATI question was, odansetron used to decrease nausea and vomiting caused by chemo. And a HESI question asked about a chemotherapy scenario. So during the infusion, a child reports nausea and vomiting.
So the priority nursing action is to stop the chemo, flush the line, and administer odansetron. Now, metoclopramide, brand name is Reglan, given for nausea and vomiting, but also for delayed gastric emptying, called gastroparesis. Now, guys, it works by accelerating gastric emptying by increasing intestinal motility. Basically, it gets food out of the stomach very quickly. And according to the HESI, it's contraindicated for clients with a bleed in the GI.
For example, a duodenal ulcer or a duodenal ulcer. Now the key point is the side effects, the extra-parameter side effects, guys. Specifically, tardive dyskinesia, especially in older adults. So key point is that we question a prescription or order and we report to the HCP immediately. So guys, keywords to write down.
Lip smacking, sucking lip motion. Guys, this was mentioned multiple times on various quiz banks. Also, puffing of the cheeks and excess blinking of the eyes. Even protruding and twisting of the tongue and chewing movement. So the memory trick is M for metoclopramide and M for major lip smacking and puffing of the cheeks.
We always report the funky face movements, guys. Now some common side effects and some common distractors. Guys, we do not need to report these. So sedation, fatigue, and restlessness, that's pretty normal.
Headache was mentioned twice on different quiz banks. Guys, it's okay. We do not hold for this complication.
Also, sleeplessness and dry mouth and constipation and even diarrhea. No, you do not hold the dose because it's easily treated. Now, for constipation, we have laxatives and stool softeners. And to be honest, it's not a huge topic on the NCLEX review.
But the big key point here is safety. So, guys, it's contraindicated for bowel obstruction. Huge risk for death.
So, first on the list is psyllium husk, which is a bulking fiber. Second is magnesium hydroxide. Brand name is milk of mag, or milk of magnesia. Now, this is considered a laxative and antiacid, which we'll be covering in the antiacid section.
Now, third is sodium docusate. Brand name is colase. Basically, it's a stool softener.
So, it increases water content in the stool to soften those hard bowels. Now, this was the... See?
only one to come up on five quiz banks as a direct question. So that's honestly all you'll need to know. And lastly, we always teach patients to increase their fluid, their fiber, and their walking to increase peristalsis, basically to get the bowel tubes moving.
Now lactulose, we call lactalose since it loosens the bowels to lower the ammonia levels. So we use the acronym LAC for lactulose. L for a laxative, A for ammonia levels that should be decreasing, and C for the cognition that returns.
So, keyword here is improved mental status. Now, it's given to decrease ammonia levels in cirrhosis patients. It treats hepatic encephalopathy, fancy words for a cloudy brain, that decreased mental status from those high levels of ammonia.
So guys, lactulose helps the body poo out all that ammonia. Basically massive explosive diarrhea. So just think lack to lose we lose that ammonia Now, some common distractors on the NCLEX. Ammonia levels decrease via the bowel. Guys, not the urine, since it's not a diuretic.
So no renal excretion of ammonia. And no, it does not decrease portal hypertension. And no, guys, abdominal distension will not improve with lactulose.
Again, it helps us lose the ammonia and lactalose via those loose bowels. Now, how does a nurse evaluate the effectiveness? Guys, write down these key points here.
Number one, two to three soft stools per day. Number two, ammonia levels are decreasing, but here is the key term. Write this down. Cognition must be improving.
So we must have improved mental status. Guys, the biggest test tip I can give you here is don't let the NCLEX trick you. Diarrhea and loose stools are not indicators. that ammonia levels are decreasing.
The only indicator here is improved mental status. That's how you know the drug is working. Now for sodium polystyrene sulfonate, the brand name is K-exolate, given for hyperkalemia, that high potassium. So guys, just think, K-exolate helps the K to exit the body, from the body into the potty. Now for administration, PO is the most effective, or we can also use an...
enema as well. Now the big key points here for patient teaching. Key words.
It helps the large intestine to remove excess potassium within the body. Most commonly chosen distractors here is guys, no contrast is used during administration and it's not used for bread-ridden clients who are constipated. That would be a fleets enema. And no, it does not decrease bacteria within the intestine. That would be a neomycin enema.
Guys, again, it decreases the excess K. So K-exolate, it exits the body. Now, thanks for watching.
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