A home health nurse is caring for a client who has chemotherapy-induced nausea that has been resistant to relief from pharmacological measures. Which of the following interventions should the nurse initiate? (Select all that apply.)
Maintain the head of the client's bed in an elevated position after eating.
Provide sips of room-temperature ginger ale between meals.
Offer 120 mL (4 oz) of cold milk as a meal replacement.
Use seasonings to enhance the flavor of foods.
Assist the client in using guided imagery.
Correct Answer : A,B,E
Interventions for Chemotherapy-Induced Nausea: Analyzing the Choices
The prompt describes a home health nurse caring for a client experiencing chemotherapy-induced nausea resistant to pharmacological interventions. We need to analyze the effectiveness of each offered intervention based on evidence and rationale:
a. Maintain the head of the client's bed in an elevated position after eating.
Rationale:
- Supportive: Some studies suggest elevating the head of the bed by 30-45 degrees might reduce gastroesophageal reflux and nausea after meals.
b. Provide sips of room-temperature ginger ale between meals.
Rationale:
- Supportive: Ginger has demonstrated antiemetic properties in several studies, potentially reducing nausea and vomiting. Room-temperature liquids are generally better tolerated than cold or hot ones for nausea.
- Considerations: The effectiveness of ginger may vary between individuals, and potential interactions with other medications should be checked.
c. Offer 120 mL (4 oz) of cold milk as a meal replacement.
Rationale:
- Unsupportive: Replacing meals with small volumes of milk is inadequate for nutritional needs and can worsen nausea due to an empty stomach. Chemotherapy can already impact appetite and nutrient intake, and offering small, frequent meals is generally recommended.
- Potential harm: Skipping meals can lead to electrolyte imbalances, dehydration, and further weaken the client.
d. Use seasonings to enhance the flavor of foods.
Rationale:
- Mixed evidence: While strong odors or unfamiliar flavors can trigger nausea in some clients, using bland or mild seasonings might not be universally effective. Some studies suggest offering preferred or familiar flavors based on individual preferences could improve appetite and tolerance.
- Individualization: Experimenting with different spices and flavors based on the client's preferences and observing their response is crucial.
e. Assist the client in using guided imagery.
Rationale:
- Supportive: Guided imagery is a relaxation technique that can help manage nausea by distracting the client from the unpleasant sensation and promoting feelings of calmness. Studies have shown its effectiveness in reducing nausea and vomiting in various contexts, including chemotherapy.
- Considerations: Not all clients may be receptive to guided imagery, and its success depends on individual preferences and practice.
In conclusion, the most appropriate interventions for the client include:
- Providing sips of room-temperature ginger ale between meals (choice b).
- Assisting the client in using guided imagery (choice e).
Choices a, c, and d require further evaluation or are not generally recommended based on current evidence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
The correct answer is Choice B because, "Compiling resources available to transition individuals from shelters to a home." Secondary prevention focuses on minimizing the impact of an event that has already occurred, and providing resources for individuals to transition from a shelter to a home can help minimize the long-term impact of the disaster.
Choice A is wrong because, "Publishing a listing of shelter locations in local media sources," is not the correct answer because it is a primary prevention strategy that focuses on preventing the negative effects of a disaster.
Choice C is wrong because, "Interviewing shelter residents to determine the effectiveness of coping behaviors," is not the correct answer because it is a tertiary prevention strategy that focuses on providing support to individuals who have already experienced negative effects of a disaster.
Choice D is wrong because, "Providing age-appropriate activities for shelter residents," is not the correct answer because it is a tertiary prevention strategy that focuses on providing support to individuals who have already experienced negative effects of a disaster.
Correct Answer is A
Explanation
The correct answer is Choice D because, reliance on written notes during the teaching session. This factor can be a barrier to learning because the nurse cannot ensure that the client and family understand the information being presented, and may miss important points that were not included in the written notes.
Choice A is wrong because, use of humor to deal with disruptive behavior, is incorrect as the use of humor can be an effective strategy to engage clients and promote learning. Choice B is wrong because, previous experience teaching HIV management courses, is incorrect as this factor can enhance the nurse's ability to effectively teach clients and families about HIV management. Choice C is wrong because, use of educational materials in written and video format, is incorrect as this factor can enhance the client's ability to understand and retain information.
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