A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication?

Choice A reason: Trouble sleeping is not a relevant information for administering pyridostigmine, which is a cholinesterase inhibitor that improves muscle strength and function in patients with myasthenia gravis. Trouble sleeping may be caused by other factors, such as stress, pain, or medication side effects.

Choice B reason: Difficulty with urination is not a pertinent information for administering pyridostigmine, which does not affect urinary function or bladder control. Difficulty with urination may indicate a urinary tract infection, prostate enlargement, or kidney stones.

Choice C reason: Unexplained weight loss is not a significant information for administering pyridostigmine, which does not affect metabolism or appetite. Unexplained weight loss may be a sign of an underlying condition, such as hyperthyroidism, diabetes, or cancer.

Choice D reason: Recent oral intake is the correct information for administering pyridostigmine, which should be taken on an empty stomach or before meals to enhance its absorption and effectiveness. Pyridostigmine can also help prevent or reduce dysphagia (difficulty swallowing), which is a common symptom of myasthenia gravis.

Choice A reason:

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has analgesic, anti-inflammatory, and antipyretic effects. Ibuprofen can be prescribed along with morphine to enhance the pain relief and reduce the inflammation caused by the surgery. Ibuprofen can also reduce the opioid requirement and the risk of opioid-related side effects, such as nausea, constipation, and respiratory depression. Therefore, choice A is correct.

Choice B reason:

Propofol is a short-acting intravenous anesthetic agent that induces and maintains anesthesia and sedation. Propofol is not prescribed along with morphine for post-operative pain management, as it is not an analgesic and has a high risk of hypotension, bradycardia, and respiratory depression. Propofol is only used in controlled settings, such as the operating room or the intensive care unit, under close monitoring and supervision. Therefore, choice B is incorrect.

Choice C reason:

Methadone is a long-acting synthetic opioid that has analgesic and opioid substitution effects. Methadone is not prescribed along with morphine for post-operative pain management, as it is not indicated for acute pain and has a high risk of accumulation, overdose, and addiction. Methadone is mainly used for chronic pain or opioid dependence treatment, under strict regulation and monitoring. Therefore, choice C is incorrect.

Choice D reason:

Senna is a stimulant laxative that increases the intestinal motility and promotes bowel movements. Senna can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Senna can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice D is correct.

Choice E reason:

Docusate sodium is a stool softener that increases the water content and softness of the stool. Docusate sodium can be prescribed along with morphine to prevent or treat constipation, which is a common side effect of opioids. Docusate sodium can improve the comfort and quality of life of the client who is receiving opioid therapy. Therefore, choice E is correct.

Choice F reason:

Naloxone is an opioid antagonist that reverses the effects of opioids by displacing them from their receptors. Naloxone is not prescribed along with morphine for post-operative pain management, as it would counteract the analgesic effect of morphine and cause withdrawal symptoms. Naloxone is only used in emergency situations, such as opioid overdose or respiratory depression, as a rescue medication. Therefore, choice F is incorrect.