A client with myasthenia gravis is given a Tensilon test. Forty minutes after the test, the client develops severe weakness and ptosis. The nurse should be prepared to:
  1. Administer atropine
  2. Administer pyridostigmine
  3. Check for constricted pupils
  4. Intubate the client
Explanation
Answer - A - Developing severe weakness within 1 hour of the administration of Tensilon indicates a cholinergic crisis, or overdose of anticholinesterase drugs. The antidote for cholinergic crisis is atropine. Choice B is incorrect because it would be inappropriate to administer an anticholinesterase drug, such as pyridostigmine, to a client in cholinergic crisis. Choice C is incorrect because checking for constricted pupils does not provide useful information. Pupil constriction does not occur during a cholinergic crisis. Choice D is incorrect because intubation is not the first action. Atropine should be used first to counteract the toxic effects of the anticholinesterase drug.
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