Which of the following patients diagnosed with Myasthenia Gravis would the nurse identify as most at risk for developing a cholinergic crisis? A patient who:
is experiencing a respiratory infection and is short of breath.
reports taking a daily extra dose of their anticholinesterase medication.
has a family history of autoimmune disorders.
has a past medical history of type 2 diabetes mellitus.
The Correct Answer is B
A. is experiencing a respiratory infection and is short of breath: While a respiratory infection and shortness of breath can exacerbate symptoms of Myasthenia Gravis (MG), this condition does not specifically increase the risk of a cholinergic crisis. However, respiratory issues can worsen during a crisis, but they are not the main trigger.
B. reports taking a daily extra dose of their anticholinesterase medication: Cholinergic crisis occurs when there is an overdose of anticholinesterase medication, which increases acetylcholine levels and causes overstimulation of the parasympathetic nervous system. Symptoms include excessive salivation, sweating, diarrhea, bradycardia, and respiratory distress. Taking an extra dose of anticholinesterase medication can lead to this crisis, making the patient most at risk in this scenario.
C. has a family history of autoimmune disorders: While a family history of autoimmune disorders might indicate a predisposition to developing autoimmune conditions, it does not directly increase the risk of a cholinergic crisis. Cholinergic crises are more specifically related to medication dosing in MG.
D. has a past medical history of type 2 diabetes mellitus: Type 2 diabetes mellitus does not have a direct correlation with an increased risk of developing a cholinergic crisis in a patient with MG. The risk of cholinergic crisis is more related to the administration of anticholinesterase medications, not diabetes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Administering aggressive medical interventions to prolong life: In the end stages of Huntington's Disease, aggressive medical interventions are generally not the priority. Huntington's is a progressive neurodegenerative disease, and prolonging life without regard to the patient's quality of life is usually not the focus. The emphasis in end-of-life care is on comfort and symptom management rather than aggressive treatments.
B. Encouraging the patient to engage in physical therapy and exercise: While physical therapy can be important earlier in the disease progression to help maintain function and mobility, in the end stages of Huntington's Disease, the patient's focus is more on comfort care. At this point, physical therapy may not be practical or helpful in improving quality of life, so it is not the primary consideration.
C. Providing comfort care and managing symptoms according to patient's wishes: This is correct. The most important consideration in end-of-life care for a patient with Huntington's Disease is to focus on comfort and symptom management. This includes addressing pain, managing emotional and psychological symptoms, and ensuring that care aligns with the patient's wishes, values, and goals. End-of-life care should prioritize maintaining dignity and ensuring the patient's comfort.
D. Providing respite care and support for the patient's family: While providing respite care and family support are very important aspects of caregiving, the most important consideration is the patient's comfort and managing symptoms in alignment with their wishes. Respite care for the family is important but is not the central focus of end-of-life care for the patient.
Correct Answer is C
Explanation
A. Providing pain management to adhere to coughing and deep breathing exercises: While pain management is important for overall comfort and encouraging deep breathing and coughing, it is not the primary intervention for managing hypoxemia due to altered alveolar diffusion. The key intervention for hypoxemia from impaired alveolar diffusion focuses more on improving oxygenation and addressing the underlying cause.
B. Teaching the client to use the tripod position: The tripod position, which involves sitting upright and leaning forward with hands on knees, can help improve breathing for patients with certain respiratory conditions (e.g., COPD), but it is not directly related to the management of hypoxemia caused by altered alveolar diffusion.
C. Adding humidity with supplemental oxygen to keep secretions thin: Hypoxemia related to altered alveolar diffusion often results from difficulty in gas exchange due to thickened secretions or inflammation. Adding humidity to supplemental oxygen helps thin the secretions, making it easier to clear them, and can improve gas exchange in the lungs, which directly helps address the hypoxemia.
D. Supplying additional oxygen while the client is at rest: While providing supplemental oxygen to maintain adequate oxygen levels is important in managing hypoxemia, this option does not specifically address the issue of altered alveolar diffusion. Humidified oxygen can be more beneficial in improving secretion clearance and promoting better diffusion in such cases.
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