A client with myasthenia gravis who is prescribed pyridostigmine comes to the emergency department complaining of abdominal cramping, excessive diarrhea, and severe muscle weakness. The nurse would suspect which of the following?
A) Underdosage of the drug
B) Tolerance to the drug
C) Cholinergic crisis
D) Underlying infection
Ans: C
Feedback:
Cholinergic crisis (cholinergic drug toxicity) symptoms include severe abdominal cramping; diarrhea; excessive salivation; muscle weakness, rigidity, and spasms; and clenching of the jaw. Signs of drug underdosage are signs of the disease itself, namely, rapid fatigability of the muscles, drooping of the eyelids, and difficulty breathing. Tolerance would be indicated by a reduction in the adverse reactions to the drug that the client was experiencing. There is no information to suggest that the client has an underlying infection.
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