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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 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 ["A","B","C","E"]

Explanation

Rationale:

A. Educating the client about the consequences of not taking valproic acid is essential to ensure they understand the importance of adherence to the medication regimen.

B. Suggesting that the client take the medication with food can help minimize gastrointestinal side effects such as nausea.

C. Documenting the client's refusal in the medication administration record is a critical step to maintain accurate medical records and to inform other healthcare providers.

D. Offering to administer the medication IM is not appropriate, as valproic acid is typically given orally and not via intramuscular injection.

E. Recommending the client ask the provider about an enteric-coated formulation may provide a more tolerable option to reduce gastrointestinal side effects.

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