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 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 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.