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 B
Explanation
Rationale:
A. Mostly cloudy: This option does not refer to a medication and is therefore irrelevant in this context.
B. Acyclovir: This is the correct medication for treating varicella-zoster virus, as it is an antiviral drug effective in managing symptoms and reducing the duration of the infection.
C. Vancomycin: This antibiotic is used to treat serious bacterial infections and is not indicated for viral infections like varicella-zoster.
D. Gentamicin: This is an aminoglycoside antibiotic that is ineffective against viral infections and is used primarily for bacterial infections.
E. Quinine: This medication is used to treat malaria and is not relevant for varicella-zoster virus treatment.
Correct Answer is D
Explanation
Rationale:
A. Acetylcysteine is not indicated for gastrointestinal bleeding; other treatments are used for that condition.
B. Acute bronchospasm is treated with bronchodilators rather than acetylcysteine.
C. Morphine toxicity requires other interventions, such as opioid antagonists (e.g., naloxone), and acetylcysteine is not effective in this case.
D. Acetylcysteine is specifically indicated for acetaminophen toxicity as it acts as an antidote, replenishing glutathione stores and preventing liver damage from toxic metabolites.