A Patient with Myasthenia Gravis Who Is Taking a Cholinesterase

question 4

Multiple Choice

A patient with myasthenia gravis who is taking a cholinesterase inhibitor is being admitted to the intensive care unit and is on mechanical ventilation. The prescriber has ordered a challenge dose of edrophonium to distinguish between a myasthenic crisis and a medication overdose. The nurse will expect to do what?

• A) Administer neostigmine if muscle strength decreases.
• B) Be prepared to administer atropine and oxygen if muscle weakness increases.
• C) Give a second dose of edrophonium if no improvement is seen.
• D) Give pralidoxime [Protopam] if cholinergic symptoms worsen.

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