Page 2028 - Saunders Comprehensive Review For NCLEX-RN

with anticholinesterase.
2. Assessment
a. Abdominal cramps
b. Nausea, vomiting, and diarrhea
c. Blurred vision
d. Pallor
e. Facial muscle twitching
f. Hypotension
g. Pupillary miosis
3. Interventions
a. Withhold anticholinesterase
medication.
b. Prepare to administer the antidote,
atropine sulfate, if prescribed.

G. Edrophonium (Tensilon) test

Have atropine sulfate available when performing the edrophonium test.

1. Description
a. This test is performed by the
neurologist to diagnose myasthenia
gravis and to differentiate between
myasthenic crisis and cholinergic
crisis.
b. The test places the client at risk for
ventricular fibrillation and cardiac
arrest; emergency equipment needs to
be available.
2. To diagnose myasthenia gravis
a. Edrophonium injection is administered
to the client.
b. Positive for myasthenia gravis: Client
shows improvement in muscle
strength after the administration of
edrophonium.
c. Negative for myasthenia gravis: Client
shows no improvement in muscle
strength, and strength may even
deteriorate after injection of
edrophonium.
3. To differentiate crisis
a. Myasthenic crisis: Edrophonium is
administered and, if strength
improves, the client needs more
medication.
b. Cholinergic crisis: Edrophonium is

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