A client diagnosed with myasthenia gravis receives a prescription for pyridostigmine. Which intervention should the nurse implement when preparing to administer this medication?

Schedule the medication to be given just before bedtime.

Break the medication into small pieces and sprinkle onto food.

Instruct the client to avoid dairy products for at least 30 minutes.

Administer the medication thirty minutes prior to meals.

Answer and Explanation

The Correct Answer is D

A. Schedule the medication to be given just before bedtime: Pyridostigmine should be timed to coincide with periods of increased activity, especially before meals, to improve muscle strength. Giving it at bedtime would not offer functional benefit unless the client experiences nighttime symptoms.

B. Break the medication into small pieces and sprinkle onto food: Pyridostigmine tablets are not designed to be crushed or split unless specifically directed. Altering the form may affect its absorption and reduce its effectiveness in managing symptoms of myasthenia gravis.

C. Instruct the client to avoid dairy products for at least 30 minutes: Dairy does not interfere significantly with the absorption or action of pyridostigmine. Dietary restrictions should be based on known drug-food interactions, which are not typically associated with pyridostigmine and dairy.

D. Administer the medication thirty minutes prior to meals: Administering pyridostigmine before meals helps enhance swallowing and chewing abilities, reducing the risk of aspiration. This timing optimizes muscle strength during eating, which is a high-risk activity for clients with myasthenia gravis.

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Correct Answer is C

Explanation

A. History of glaucoma: Glaucoma history is relevant for some medications that increase intraocular pressure, but misoprostol primarily affects the gastrointestinal and reproductive systems. It does not typically worsen glaucoma or require caution for that condition.

B. Taking an antiemetic medication: Although gastrointestinal side effects like nausea can occur with misoprostol, concurrent antiemetic use is not a contraindication. This information is less critical before the first dose compared to other more serious concerns.

C. Currently pregnant: Misoprostol is contraindicated during pregnancy because it can stimulate uterine contractions and cause miscarriage. Determining pregnancy status is crucial before administering the drug to prevent serious harm to both the client and fetus.

D. Allergy to aspirin: While clients with certain allergies require careful medication review, misoprostol is not a nonsteroidal anti-inflammatory drug (NSAID) and does not cross-react with aspirin allergies. Confirming pregnancy status is the more immediate priority.

A. Review most recent coagulation laboratory values. B. Report findings to healthcare provider (HCP). C. Complete a medication variance report. D. Obtain a soft bristle toothbrush for client. E. Provide a PRN nonsteroidal antiinflammatory drug (NSAID) for gum discomfort.

Correct Answer is ["A","B","D"]

Explanation

A. Review most recent coagulation laboratory values: Checking coagulation studies like INR, PT, or aPTT is essential to assess the client's bleeding risk and determine if the anticoagulant effect is too strong, helping guide further medical management.

B. Report findings to healthcare provider (HCP): Bleeding gums and easy bruising are signs of excessive anticoagulation, which could become life-threatening. Promptly notifying the HCP allows for immediate evaluation and possible adjustment of the medication.

C. Complete a medication variance report: A medication variance report is appropriate when there is an error in prescribing, dispensing, or administering. Since this appears to be a medication side effect rather than an error, a variance report is not needed at this stage.

D. Obtain a soft bristle toothbrush for client: Using a soft toothbrush minimizes trauma to the gums, helping to reduce the risk of further bleeding while still maintaining oral hygiene, an important supportive intervention for clients on anticoagulants.

E. Provide a PRN nonsteroidal antiinflammatory drug (NSAID) for gum discomfort: NSAIDs increase the risk of bleeding and should be avoided in clients taking anticoagulants. Treating discomfort with NSAIDs could worsen bleeding complications rather than relieve them safely.

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A client diagnosed with myasthenia gravis receives a prescription for pyridostigmine. Which intervention should the nurse implement when preparing to administer this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to administration of the initial dose of the gastrointestinal (GI) agent misoprostol, which information should the nurse obtain from the client?

Correct Answer is C

Explanation

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which action(s) should the nurse implement? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

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