The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?
Excessive salivation
Respiratory paralysis
Muscle weakness
Muscle spasms
The Correct Answer is C
A) Excessive salivation: Neostigmine (Prostigmin) is a cholinesterase inhibitor, which works by increasing the levels of acetylcholine at neuromuscular junctions. If a dose is missed, excessive salivation can be a side effect of too much acetylcholine activity, but it is not the most immediate symptom in this case. Muscle weakness is a more direct consequence of a missed dose.
B) Respiratory paralysis: While respiratory weakness or paralysis can occur in myasthenia gravis, it is usually associated with a severe form of the disease or if the patient is in a myasthenic crisis. A single missed dose of neostigmine typically does not result in respiratory failure unless the patient is already in a very fragile state.
C) Muscle weakness: Neostigmine helps to improve neuromuscular transmission by inhibiting the breakdown of acetylcholine, which is crucial for muscle contraction. A missed dose would directly lead to a reduction in acetylcholine levels, exacerbating the characteristic muscle weakness of myasthenia gravis. Muscle weakness is the most anticipated symptom when neostigmine is not administered on time.
D) Muscle spasms: Muscle spasms are typically not a symptom of missed neostigmine therapy. Instead, muscle weakness occurs due to impaired neuromuscular transmission. Spasms might occur if there is significant overstimulation of the muscles, but this is more associated with electrolyte imbalances or other neuromuscular issues
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Monoamine oxidase:
Monoamine oxidase (MAO) is an enzyme, not a neurotransmitter. It is responsible for breaking down certain neurotransmitters, such as dopamine, serotonin, and norepinephrine, in the brain and other parts of the body. While it plays a crucial role in regulating neurotransmitter levels, it is not itself a neurotransmitter.
B) Cholinesterase:
Cholinesterase is also an enzyme, not a neurotransmitter. It breaks down acetylcholine (ACh) at synaptic junctions to terminate its action after it has transmitted a nerve impulse. This enzyme is important for the proper functioning of cholinergic synapses but does not function as a neurotransmitter.
C) Acetylcholine (ACh):
Acetylcholine (ACh) is a neurotransmitter. It is released by nerve cells at cholinergic synapses and plays a key role in both the peripheral and central nervous systems. ACh is involved in transmitting nerve impulses to muscles (muscle contraction) and is also important in cognitive functions like memory and learning in the brain.
D) Calcium:
Calcium is a vital ion involved in many cellular processes, including muscle contraction and neurotransmitter release. However, it is not a neurotransmitter. It plays a role in the function of neurotransmitters but does not act as one itself.
Correct Answer is C
Explanation
A) Feed cells under stress:
The primary function of the homeostasis control systems is not to directly "feed" cells under stress, but to regulate internal balance and ensure all systems are functioning optimally, particularly in response to changes in the environment or internal states. "Feeding" or providing nutrients is a broader metabolic process rather than a direct function of the homeostasis control systems.
B) Act on invading organisms:
While the immune system, which plays a role in defending the body against invading organisms, is a part of overall body regulation, homeostasis itself is more concerned with maintaining internal stability. The control systems of the body regulate physiological processes such as temperature, pH, and fluid balance rather than directly targeting external organisms like bacteria or viruses, which would fall under the immune response.
C) Control vital functions:
Homeostasis control systems are integral in maintaining the body's internal environment, ensuring stability for vital functions such as temperature, heart rate, blood pressure, and respiratory rate. These systems help adjust these functions in response to various internal and external stimuli to maintain optimal conditions for survival, making this the most accurate answer.
D) Shut down the body at death:
While the control systems ultimately cease to function at death, the purpose of homeostasis during life is to maintain the balance of bodily functions, not to cause the cessation of life. The homeostatic mechanisms are about maintaining life and health, preventing "shutdown" until the point of death.
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