A nurse is caring for a client receiving cholinergic medications to assist in the treatment of myasthenia gravis. Which contraindication will the nurse assess for prior to administering a cholinergic medication?
Asthma
Hypertension
Alzheimer's
Diarrhea
The Correct Answer is A
A. Asthma is a contraindication for cholinergic medications because these drugs can cause bronchoconstriction and may exacerbate respiratory conditions. Careful assessment is necessary before administration to ensure safety.
B. Hypertension is not a direct contraindication for cholinergic medications; they may not significantly affect blood pressure in most cases.
C. Alzheimer's disease is not a contraindication for cholinergic medications; in fact, cholinergic agents may be used to improve cognitive function in some patients with dementia.
D. Diarrhea is not a contraindication for cholinergic medications but may indicate excessive cholinergic activity; it should be monitored, but it does not prevent administration.
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Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.
Correct Answer is A
Explanation
A. Ciprofloxacin is a fluoroquinolone antibiotic that is effective against Bacillus anthracis, the bacterium that causes anthrax. It is often used as a first-line treatment for exposure to anthrax, especially in its inhalational form.
B. While amoxicillin/clavulanate can treat certain infections, it is not the preferred treatment for anthrax. It is less effective against anthrax compared to ciprofloxacin.
C. Nystatin is an antifungal medication used to treat fungal infections and is not indicated for anthrax treatment.
D. Metronidazole is primarily used for anaerobic bacterial and protozoal infections, making it inappropriate for treating anthrax.