A nursing student is discussing with a nurse the plan of care for a patient about to undergo a third round of chemotherapy with cisplatin. Which statement by the nursing student about the treatment of CINV is correct?

Question

a. "Aprepitant [Emend] will be necessary to treat CINV caused by cisplatin."
b. "Antiemetics are most effective if given just as the chemotherapy is finished."
c. "Lorazepam probably would not be help-ful for this patient."
d. "This patient will need intravenous anti-emetics for best effects."

Answer 1

A
CINV caused by cisplatin is maximal 48 to 72 hours after dosing and can persist for 6 to 7 days, so an antiemetic such as aprepitant, which treats delayed emesis, is an important part of anti-emetic therapy. Antiemetics should be started 30 minutes before initiation of chemotherapy. Lo-razepam should be given to this patient, because the patient has had some experience with che-motherapy and is likely to have anticipatory emesis. There is no benefit to IV over oral dosing unless the patient has ongoing emesis.