Question

Case study: Nellie Snyder is a 38-year-old woman with breast cancer who is receiving radiation and chemotherapy. She is experiencing significant nausea and vomiting. Her oncologist orders ondansetron 8 mg IV to be administered 30 minutes prior to her chemotherapy and 8 to 16 mg PO every 8 hours as needed. She also receives metoclopramide 10 mg PO four times a day (30 minutes before meals and at bedtime).

1. Ms. Snyder is concerned about the amount of medication she is receiving. She asks the nurse to withhold her antiemetics until she actually vomits. What is the best way to respond to Ms. Snyder? (3 points)

2. Check Ms. Snyder’s ordered dose. Is it in the appropriate dose range? (1 points)

3. What adverse effects will you monitor for in Ms. Snyder after administering the ondansetron IV? (2 points)

Ms. Snyder is amazed at how fast the ondansetron works when it is given IV. She states that she is concerned when she starts taking it orally that it may not work as quickly.

4. What can you tell Ms. Snyder about when the oral form of ondansetron will take effect and when the action will peak? (2 point)

Answer 1

Q1

Answer: Advice to the patient that it is compulsory to give antiemetic injection 30 minutes before the chemotherapy because obviously vomiting is the sign of chemotherapy and at least 30 minutes is needed to react the action of an antiemetic in the body. This is given for the preventive measure from the vomiting not to give when she have the vomit. Advised that she is not vomiting because of this preventive measure.

Q2

Answer:The dose is appropriate as the dose of antiemetic in first line is 8 mg twice a day or 16 mg per day. As the physician prescribed 8 mg Iv before the chemotherapy and orally when needed 8-16 mg every 8 hours whenever needed.

Q3

Answer: The adverse effects due to administration of Ondansetron are weakness, dizziness, tiredness, constipation chest pain, toxicity, allergic reaction of the drug.

Q4

Answer: Advised the patient that ondansetron can take orally but it take time to act on the body as compared to IV injection. It takes around 2-3 hours to peak the plasma level. Mostly advise to take the antiemetic drugs before the meals or breakfast.