The nurse identifies the client exhibiting supraventricular tachycardia and calls the provider. Several orders are given. For which of the following orders would the nurse request further clarification? (Select all that apply)

Choice A reason: Consuming a high purine diet is not related to myasthenic crisis. High purine diets are more commonly associated with conditions like gout, where uric acid levels become elevated.

Choice B reason: Taking too much of their medication can lead to a cholinergic crisis, not a myasthenic crisis. A cholinergic crisis occurs due to excessive accumulation of acetylcholine, often from overmedication with anticholinesterase drugs.

Choice C reason: Taking too little of the prescribed medication is the primary precipitating factor for a myasthenic crisis. Inadequate levels of medication lead to insufficient acetylcholine at neuromuscular junctions, causing severe muscle weakness and potentially life-threatening respiratory failure. This situation requires immediate medical intervention to stabilize the patient.

Choice D reason: Taking medication on an empty stomach may affect absorption rates, but it is not a direct precipitating factor for a myasthenic crisis. The crisis is more closely linked to under-medication or missed doses of anticholinesterase drugs.

Choice A reason: Nausea is a common symptom of digoxin toxicity. Elevated levels of digoxin can cause gastrointestinal disturbances, including nausea.

Choice B reason: Vomiting is also a common symptom of digoxin toxicity. The medication can irritate the stomach and lead to vomiting.

Choice D reason: Hyperglycemia is not typically associated with digoxin toxicity. This symptom is unrelated to the effects of elevated digoxin levels.

Choice E reason: Photophobia is not a common symptom of digoxin toxicity. Symptoms of digoxin toxicity are more likely to be gastrointestinal or cardiovascular in nature.