A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?
Recent oral intake.
Trouble sleeping.
Unexplained weight loss.
Difficulty with urination.
The Correct Answer is A
A) Recent oral intake: This information is important because pyridostigmine is typically administered orally and can interact with food, affecting its absorption. It is essential to ensure that the client has recently eaten or will eat soon to minimize gastrointestinal side effects and optimize medication absorption.
B) Trouble sleeping: While sleep disturbances can be a concern, particularly if they worsen with medication use, it may not be the most critical information to obtain before administering pyridostigmine. However, if the client experiences worsening sleep disturbances after starting the medication, it should be reported to the healthcare provider.
C) Unexplained weight loss: While weight loss can be a symptom of myasthenia gravis, it may not be directly related to the administration of pyridostigmine. However, if the client experiences significant weight loss or other unexplained symptoms, further assessment and evaluation may be necessary.
D) Difficulty with urination: Pyridostigmine can affect bladder function and may exacerbate urinary retention, especially in clients with myasthenia gravis. However, obtaining information about the client's recent oral intake is more crucial to ensure optimal medication absorption and minimize gastrointestinal side effects. Difficulty with urination should still be monitored, but it may not be the most immediate concern before administering the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Breastfeeding is not recommended while taking this medication: While it’s important for clients to avoid breastfeeding while taking isotretinoin due to potential harm to the infant, the primary concern for a young adult female planning to become pregnant is the risk of teratogenic effects on the fetus. Therefore, while this information is relevant, it’s not the most important consideration in this situation.
B) Do not take multiple vitamins that contain vitamin A while taking this drug: Avoiding excessive intake of vitamin A is essential to prevent toxicity, but it’s not the most critical consideration for a client planning to become pregnant. The main concern is the teratogenic effects of isotretinoin on the fetus.
C) Baseline liver function results must be obtained during therapy: Monitoring liver function is important during isotretinoin therapy to assess for potential hepatotoxicity, but it’s not the most crucial consideration for a client planning to become pregnant. The primary concern is the need to discontinue the medication before conception to prevent fetal exposure.
D) Discontinue this medication one month before attempting to conceive: This is the most important information for the nurse to provide to the client. Isotretinoin is highly teratogenic and can cause severe birth defects if taken during pregnancy. Therefore, it’s essential for the client to discontinue isotretinoin at least one month before attempting to conceive to ensure the drug is cleared from the body and to prevent fetal exposure.
Correct Answer is B
Explanation
A) Evaluate the client's ability to recognize the urge to defecate: Assessing the client's ability to recognize the urge to defecate is important for promoting independence in toileting. However, this assessment may not directly indicate the need for administering a laxative. It is more relevant for clients who are able to ambulate or have control over their bowel movements.
B) Determine the frequency and consistency of bowel movements: Assessing the frequency and consistency of bowel movements provides valuable information about the client's bowel function and helps determine the need for a laxative. It allows the nurse to establish a baseline and evaluate the effectiveness of interventions. Understanding the client's typical bowel pattern is crucial before administering a laxative to avoid overmedication or potential complications such as diarrhea or fecal impaction.
C) Observe the skin integrity of the client's rectal and sacral areas: Assessing skin integrity in the rectal and sacral areas is crucial for preventing pressure ulcers, especially in bedfast clients. However, it is not directly related to the need for administering a laxative.
D) Assess the client's strength in moving and turning in the bed: While assessing the client's strength and mobility is important for overall care and prevention of complications related to immobility, it may not be directly related to the need for administering a laxative. This assessment is more relevant for preventing complications such as pressure ulcers and maintaining musculoskeletal function.
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