9.9 Clinical Reasoning and Decision-Making Learning Activities

1. A nurse is caring for a client who underwent surgery earlier today and is experiencing nausea and vomiting. The original post-op orders included prochlorperazine, but the client continues to experience vomiting despite receiving this medication. The nurse calls the provider and receives a new order for ondansetron orally dissolving tablets, 8 mg three times daily as needed.

a. How will the nurse assess for symptoms of dehydration?

b. When administering the medication, the client states, “I don’t think I can swallow anything right now. Is there another way I can get this med?” What is the nurse’s best response?

c. What other measures should the nurse teach the clients to reduce feelings of nausea and avoid dehydration?

2. A 82 year old client has been admitted for partial bowel obstruction due to fecal impaction. She has a number of health issues  including atrial fibrillation, hypertension and GERD. She tells the nurse she is quite nauseated.  The nurse considers two anti-emetics, which one is best for this client? metoclopramide or ondansetron? Explain your answer.

Note: Answers to the Clinical Reasoning Activities and Critical Thinking questions can be found in the Chapter 9: Gastrointestinal Medications Answer Key – Fundamentals of Nursing Pharmacology – 2nd Canadian Edition sections at the end of the book.