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 D
Explanation
Rationale:
A. Mostly cloudy: This option appears to be incorrectly stated. It does not pertain to a critical client assessment related to morphine administration.
B. Apical heart rate: Monitoring the heart rate is important, but respiratory depression is a more immediate and life-threatening concern with morphine administration, so it is not the first priority.
C. Blood pressure: Morphine can cause hypotension, but this is not as critical as respiratory depression, which must be assessed first in opioid administration.
D. Respiratory rate: The most critical assessment when administering morphine is the respiratory rate, as opioid medications like morphine can cause respiratory depression, which can be life-threatening if not addressed.
E. Level of consciousness: While important, changes in consciousness typically follow respiratory depression, so assessing the respiratory rate takes priority.
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.