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
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.