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 C
Explanation
Rationale:
A. Delaying the incident report until the end of the current shift can compromise the timely documentation of the error and any necessary interventions that may arise.
B. While it's important to notify risk management, the priority should be to document the incident immediately after assessing the client to ensure a complete record of the error.
C. Completing the incident report as soon as the assessment is complete is the most appropriate action, allowing for prompt documentation of the error and any potential effects on patient care.
D. Informing the previous nurse is necessary for communication, but it should not delay the completion of the incident report, which is crucial for tracking errors and improving safety protocols.
Correct Answer is B
Explanation
Rationale:
A. Abbreviate "daily" as "QD": The abbreviation "QD" is no longer recommended because it can be confused with "QID" (four times daily), potentially leading to dangerous medication errors.
B. Abbreviate "by mouth" as "PO": "PO" is the standard and accepted abbreviation for "by mouth," and it is widely used in medical documentation without ambiguity.
C. Abbreviate "acetaminophen" as "APAP": "APAP" is not universally recognized and may lead to confusion. Using the full name of the drug "acetaminophen" is safer and clearer.
D. Abbreviate "at bedtime" as "qhs": "Qhs" is discouraged as it can be easily misinterpreted. Writing "at bedtime" without abbreviations is the recommended practice to avoid errors.