Author Question: The client with myasthenia gravis becomes increasingly weaker. The physician injects a dose of ... (Read 41 times)

Caiter2013 · **on:** Jul 22, 2018

The client with myasthenia gravis becomes increasingly weaker. The physician injects a dose of edrophonium (Tensilon) to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis.

The nurse expects that the client will have which of the following reactions if the client is in cholinergic crisis? 1. No change in the condition
2. Complaints of muscle spasms
3. An improvement of the weakness
4. A temporary worsening of the condition

Question 2

The client has been defibrillated unsuccessfully three times using an automatic external defibrillator (AED). The nurse determines that which of the following actions should be taken next?

1. Defibrillate one more time, and then terminate the resuscitation effort.
2. Perform cardiopulmonary resuscitation (CPR) for 5 minutes, and then defibrillate three more times.
3. Administer sodium bicarbonate intravenously, and resume defibrillation attempts.
4. Perform cardiopulmonary resuscitation (CPR) for 1 minute, assess, and then de-fibrillate up to three more times.

diesoon · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

4

Rationale: An edrophonium (Tensilon) injection makes the client in cholinergic crisis temporarily worse. An improvement of the condition (an improvement of the weakness) indicates myasthenic crisis. The other two options are unrelated to the test.

Answer to Question 2

4

Rationale: After three unsuccessful defibrillation attempts, CPR should be done for 1 minute, followed by three more shocks if they are needed. It is critically important that advanced cardiac life support (ACLS) become available as soon as possible. Each of the other options is incorrect.