Which of the following drug administrations during post postoperative

period will cause nausea and vomiting?

Appeared in: NORCET 1 - 2020

Explanation

Tramadol is a centrally-acting opioid analgesic.
A primary and common side effect of all opioid medications is postoperative nausea and vomiting (PONV).
Opioids induce nausea by directly stimulating the chemoreceptor trigger zone (CTZ) in the brainstem and by decreasing gastrointestinal motility.

Option A: Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). While it can cause GI irritation, it is not a primary cause of PONV.
Option B: Paracetamol is a non-opioid analgesic that is well-tolerated and not typically associated with causing nausea and vomiting.
Option D: Ondansetron is an antiemetic medication. Its purpose is to prevent and treat nausea and vomiting, not cause it.

Visual 1: Diagram: A flowchart illustrating the mechanism of opioid-induced nausea and vomiting, showing the stimulation of the chemoreceptor trigger zone (CTZ) and its pathway to the vomiting center in the brain.
Visual 2: Infographic: A comparison table of common postoperative analgesics (Opioids, NSAIDs, Paracetamol) listing their primary use, mechanism, and key side effects, highlighting nausea/vomiting for opioids.

Clinical Relevance

Nursing practice connection: Use the key finding related to Pharmacological side effects in postoperative care to guide bedside assessment, documentation, and the next nursing action.
A key nursing responsibility is to assess for, prevent, and manage postoperative nausea and vomiting (PONV), as it can lead to dehydration, electrolyte imbalance, and patient distress.
Nurses should be aware of the risk factors for PONV (e.g., female gender, history of motion sickness, use of opioids) and advocate for prophylactic antiemetics.
Employing multimodal analgesia (using different classes of pain medications) is a crucial strategy to reduce the total amount of opioids administered, thereby decreasing the incidence and severity of side effects like PONV.

How to Approach the Question

First, read the question carefully to identify the key concept: which drug causes nausea and vomiting postoperatively.
Next, analyze each option by identifying its drug class and primary function.
Option A (Diclofenac) is an NSAID. Recall that NSAIDs are not a primary cause of PONV.
Option B (Paracetamol) is a non-opioid analgesic, also not a primary cause of PONV.
Option C (Tramadol) is an opioid. A major, well-known side effect of opioids is nausea and vomiting.
Option D (Ondansetron) is an antiemetic. Its function is to treat nausea and vomiting.

Concept Tested & Keywords

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Practise the full NORCET 1 - 2020

Attempt every question from this paper in a timed mock, then review the full solution for each one.