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. Use insulin sliding scale until symptoms are resolved: Starting insulin without an evaluation would be inappropriate. A sliding scale may eventually be needed if blood sugars fluctuate, but the priority is to assess the cause of the gastrointestinal symptoms first.

B. Return to the clinic for laboratory tests for an infection: Although an infection could be a cause, nausea, vomiting, and diarrhea in a diabetic client also raise concern for possible medication issues, dehydration, or even metabolic disturbances. Immediate evaluation is necessary before simply ordering lab tests.

C. Schedule a visit for evaluation by the healthcare provider (HCP): New gastrointestinal symptoms could indicate a significant underlying issue such as medication intolerance, dehydration, or even diabetic ketoacidosis (though less common in type 2). An urgent clinical assessment by the HCP is most appropriate.

D. Increase oral fluid intake until these symptoms subside: While staying hydrated is important, advising fluids alone without a thorough assessment risks missing a serious underlying cause. Symptom management should not replace a proper medical evaluation.

A. Excessive bruising. B. Muscle tenderness.. C. Nausea and vomiting. D. Peripheral edema.

Correct Answer is B

Explanation

A. Excessive bruising: While statins can rarely affect platelet function, leading to bruising, this is not commonly associated with elevated creatine kinase (CK) levels. Bruising is more indicative of coagulation issues rather than muscle injury.

B. Muscle tenderness: Elevated CK levels in a client taking atorvastatin suggest muscle injury, such as myopathy or rhabdomyolysis. Muscle tenderness, pain, or weakness are hallmark symptoms of these conditions. Prompt assessment is crucial, as continued statin use in the presence of muscle damage can lead to serious complications, including kidney failure .

C. Nausea and vomiting: These symptoms are nonspecific and can result from various causes. While they may occur in rhabdomyolysis, they are not primary indicators and should be considered in the broader clinical context.

D. Peripheral edema: Swelling in the extremities is not a typical sign of statin-induced muscle injury. It is more commonly associated with cardiac, renal, or hepatic conditions.

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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

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Correct Answer is B

Explanation

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