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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Temperature of 100.8° F (38.2° C): A mildly elevated temperature in a post-transplant client may suggest infection or early rejection, both of which warrant monitoring. However, this is not a direct reason to withhold cyclosporine, which is essential for preventing organ rejection.
B. Elevated blood urea nitrogen (BUN): Elevated BUN could indicate impaired renal function, which should be monitored during cyclosporine therapy. However, this alone is not an urgent reason to withhold the medication without further evaluation of kidney function trends and symptoms.
C. Renal output of 120 mL/hour: This is a healthy urine output and suggests good renal perfusion and function. It does not present any contraindication to continuing cyclosporine and supports that the transplanted kidney is functioning well.
D. Blood pressure 180/98 mm Hg: Hypertension is a known side effect of cyclosporine and can become severe. A blood pressure this high, especially when accompanied by headache and blurred vision, suggests possible cyclosporine-induced hypertensive crisis or toxicity, and warrants immediate withholding of the medication and notification of the HCP.
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Explanation
Oral carbohydrates: The client is not currently hypoglycemic; in fact, the blood glucose is elevated at 279 mg/dL. Oral carbohydrates are typically given to treat low blood glucose, not high glucose. Administering carbohydrates here would worsen hyperglycemia.
Insulin lispro: The client’s blood glucose is significantly elevated and requires correction. Insulin lispro is a rapid-acting insulin designed to lower high blood glucose quickly, making it the correct medication to administer while monitoring closely for improvement.
Insulin glargine: Although the client is prescribed insulin glargine once daily, she has already received her dose earlier this morning before surgery. Giving another dose now would risk insulin stacking and dangerous hypoglycemia later, so it is not safe to administer at this point.
A bolus of IV fluids: The client is showing signs of early dehydration — thirst and low urine output — likely due to hyperglycemia-induced osmotic diuresis. Administering a bolus of IV fluids will help restore circulating volume, prevent further dehydration, and support tissue perfusion.
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