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?
Cataracts
Hypertension
Hypothyroidism
Peptic ulcer disease
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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Correct Answer is D
Explanation
Rationale:
A. A respiratory rate of 24/min is elevated and may suggest respiratory distress, but it is not a specific adverse effect of propranolol.
B. An oral temperature of 38.9° C (102° F) indicates fever, which is not a typical adverse effect of propranolol.
C. A blood pressure of 118/78 mm Hg is within normal limits and does not indicate an adverse effect of propranolol, which is often used to manage hypertension.
D. An apical pulse of 50/min indicates bradycardia, a known adverse effect of propranolol, which can occur due to its action on the heart rate.
Correct Answer is A
Explanation
Rationale:
A. "Leuprolide decreases the production of testosterone.": Leuprolide is a gonadotropin-releasing hormone (GnRH) agonist that works by reducing testosterone production, which is essential for the growth of prostate cancer cells. This mechanism slows the progression of the cancer.
B. "Leuprolide kills cells at all stages of cellular division.": This describes how chemotherapy drugs work, but leuprolide does not function by directly killing cancer cells at different stages of their division.
C. "Leuprolide increases estrogen levels in your body to counteract the cancer cells.": Leuprolide does not increase estrogen levels. Instead, it reduces testosterone levels, which is more effective in managing prostate cancer.
D. "Leuprolide suppresses the pituitary gland's production of growth hormone to decrease cancer cellular growth.": Leuprolide suppresses the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), not growth hormone, to decrease testosterone levels.