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. Sargramostim is a granulocyte-macrophage colony-stimulating factor (GM-CSF) used to stimulate the production of white blood cells but is not specifically indicated for anemia.
B. Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that increases white blood cell counts and is not used for treating anemia.
C. Epoetin is an erythropoiesis-stimulating agent that stimulates red blood cell production, making it the appropriate choice for treating chemotherapy-induced anemia.
D. Romiplostim is a thrombopoietin receptor agonist used to treat thrombocytopenia (low platelet count) and is not indicated for anemia.
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.