A nurse is caring for a client who is receiving high-dose metalopramide. The nurse should monitor the client for which of the following adverse effects?

A) Document the administration of the medication: Documentation of medication administration is an essential step in the medication administration process, ensuring accurate recording of the time, dose, route, and client's response to the medication. However, before administering a controlled substance, the nurse should first identify the client using two identifiers to prevent medication errors.

B) Identify the client using two identifiers: This is the correct initial action. Verifying the client's identity using two identifiers, such as name and date of birth, is a crucial safety measure to ensure that the medication is administered to the correct individual. By confirming the client's identity, the nurse helps prevent medication errors and promotes patient safety.

C) Remove the medication from the medication dispensing cabinet: While obtaining the medication from the medication dispensing cabinet is necessary for administration, it should occur after confirming the client's identity. Identifying the client using two identifiers is the priority to ensure accurate medication administration.

D) Compare the amount of medication available to the inventory record: Verifying the amount of medication available against the inventory record is an important step in medication management to maintain adequate stock levels and prevent medication shortages. However, it is not the first action the nurse should take before administering a controlled substance. Confirming the client's identity is the priority to ensure safe medication administration.

A) Increased urinary output: Ondansetron is a 5-HT3 receptor antagonist commonly used to prevent and treat nausea and vomiting, particularly in chemotherapy-induced nausea and vomiting and postoperative nausea and vomiting. While increased urinary output may be indicative of improved hydration status or renal function, it is not a direct indicator of ondansetron's effectiveness in controlling nausea and vomiting. Therefore, it is not the most appropriate finding to assess the effectiveness of ondansetron.

B) Reduced dizziness: Ondansetron primarily targets nausea and vomiting by blocking serotonin receptors in the gastrointestinal tract and the chemoreceptor trigger zone. While dizziness may sometimes accompany nausea and vomiting, its reduction may not directly correlate with the effectiveness of ondansetron. Additionally, dizziness can have various causes beyond nausea and vomiting, such as orthostatic hypotension or vestibular dysfunction. Therefore, reduced dizziness alone may not reliably indicate the effectiveness of ondansetron.

C) Absence of peripheral neuropathy: Peripheral neuropathy refers to damage or dysfunction of peripheral nerves, commonly resulting in symptoms such as numbness, tingling, or weakness in the extremities. Ondansetron is not indicated for the treatment of peripheral neuropathy, and its effectiveness in controlling nausea and vomiting would not directly influence the presence or absence of peripheral neuropathy. Therefore, this finding is unrelated to the effectiveness of ondansetron in managing nausea and vomiting.

D) Decreased nausea: Ondansetron is primarily prescribed to alleviate nausea and vomiting associated with various conditions. Therefore, a decrease in nausea would indicate that ondansetron is effective in achieving its therapeutic goal. Assessing the client's level of nausea and observing a reduction in nausea symptoms after administering ondansetron is a direct and appropriate way to evaluate its effectiveness in controlling nausea and vomiting. Thus, decreased nausea is the most accurate indicator of ondansetron's effectiveness among the options provided.