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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

Explanation

Rationale:

A. Increase calcium intake: Leuprolide can cause a decrease in bone density, increasing the risk of osteoporosis. Therefore, the nurse should advise the client to increase calcium and vitamin D intake to help maintain bone health.

B. Keep the solution cold for administration: Leuprolide should be stored at room temperature, not refrigerated, for subcutaneous administration.

C. This medication can cause low blood glucose levels: Leuprolide does not typically affect blood glucose levels. However, it can cause other endocrine-related side effects, such as hot flashes and reduced libido.

D. This medication can cause constipation: Constipation is not a common side effect of leuprolide. Instead, leuprolide is more likely to cause side effects such as hot flashes and loss of bone density.

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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