A nurse is providing discharge teaching to a client who has generalized myasthenia gravis. Which of the following information should the nurse include?

Cholinesterase inhibitors (e.g., pyridostigmine) improve muscle strength by preventing the breakdown of acetylcholine. Eating within 45 minutes of taking the medication takes advantage of peak drug effect, when swallowing is strongest and aspiration risk is lowest. A speech therapist (not occupational therapist) addresses swallowing and aspiration techniques. Meals should be eaten when energy is highest — usually earlier in the day, not in the evening when fatigue peaks. Extending the neck is contraindicated as it increases aspiration risk; chin-tuck is the correct technique.