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A nurse is reviewing the medical history of a client who has myasthenia gravis and is asking about starting neostigmine. The nurse should identify which of the following client conditions as a potential contraindication for cholinesterase inhibitor therapy?

A.

Cataracts

B.

Hypertension

C.

Hypothyroidism

D.

Peptic ulcer disease

Answer and Explanation

The Correct Answer is D

Rationale:

 

A. Cataracts are not a contraindication for cholinesterase inhibitors like neostigmine.

 

B. Hypertension is not a direct contraindication for cholinesterase inhibitor therapy, although caution may be exercised depending on the overall health status of the client.

 

C. Hypothyroidism is not contraindicated for cholinesterase inhibitors; however, it should be managed appropriately.

 

D. Peptic ulcer disease is a significant contraindication for cholinesterase inhibitors like neostigmine because these medications can increase gastric secretions and motility, potentially exacerbating ulcer conditions and leading to complications.

 


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View Related questions

Correct Answer is A, B, C, D, E

Explanation

Rationale:

  • Administering albuterol first is crucial because it is a bronchodilator that will help open the airways before administering the anti-inflammatory fluticasone.

  • The client should rest for 1 minute between puffs of albuterol to allow for the medication to take effect.

  • After taking the second puff of albuterol, a longer rest of 5 minutes allows the client to experience the full effects of the bronchodilator.

  • Finally, administering fluticasone afterward will help reduce inflammation in the airways, maximizing the benefit of both medications.

Correct Answer is B

Explanation

Rationale:

A. Nitrates: Nitrates are primarily used to manage angina or heart conditions and are unrelated to acetazolamide or its potential for allergic reactions.

B. Sulfa-based medications: Acetazolamide is a carbonic anhydrase inhibitor that contains sulfonamide groups. Clients with a sulfa allergy may experience a cross-sensitivity reaction, so it's important to confirm any history of sulfa allergies before administration.

C. Mostly cloudy: This option does not relate to any medication classification and is incorrect.

D. Antilipemic agents: Antilipemics are used to lower cholesterol and are not related to acetazolamide or its potential for allergic reactions.

E. Proton pump inhibitors: Proton pump inhibitors are used to reduce stomach acid and do not have a known cross-sensitivity with acetazolamide.

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