A prescriber has ordered a cholinesterase inhibitor for a patient ...

[Mr.Thesaxman]

A prescriber has ordered a cholinesterase inhibitor for a patient with myasthenia gravis. The prescriber's orders also instruct the nurse to monitor the patient closely after the first small initial dose.
 
  Optimal dosage of cholinesterase inhibitors for patients with myasthenia gravis is indicated by a. muscle relaxation.
  b. miosis.
  c. increased intestinal tone and motility.
  d. increased ability to raise the eyelids.

Question 2

The nurse is caring for a patient who has just been admitted to the unit. For which of the following diseases would the nurse carefully monitor the patient in anticipation of a delayed-type hypersensitivity reaction?
 
  a. Tuberculosis
  b. Influenza
  c. Hepatitis
  d. Adenovirus

[beccamahon]

Answer to Question 1

D
Important signs of improvement for patients with myasthenia gravis center around an increase in voluntary muscle control, as exhibited by an ease in swallowing and increased ability to raise the eyelids.
Muscle relaxation or laxity is a symptom consistent with myasthenia gravis and would not indi-cate a positive effect of cholinesterase inhibitor therapy.
Miosis would provide no indication that muscle tone has improved secondary to the use of cho-linesterase inhibitors.
Increased intestinal tone would provide no indication that muscle tone has improved secondary to the use of cholinesterase inhibitors.

Answer to Question 2

A
The nurse should monitor the patient for tuberculosis, because the object of delayed-type hyper-sensitivity is to rid the body of bacteria that replicate primarily with macrophages (e.g., Listeria monocytogenes, Mycobacterium tuberculosis).
Influenza, hepatitis, and adenovirus do not cause delayed-type hypersensitivity reactions.

[Mr.Thesaxman]

Thanks for the timely response, appreciate it

[Liddy]

Excellent