What indicates that a client is in cholinergic crisis after an edrophonium injection?

A temporary worsening of the condition following an edrophonium injection indicates a cholinergic crisis because edrophonium is a short-acting acetylcholinesterase inhibitor. In the context of myasthenia gravis, an increase in acetylcholine can lead to an overwhelming stimulation of the neuromuscular junction and exacerbation of symptoms.

When a patient is experiencing a cholinergic crisis, it signifies an excess of acetylcholine at the neuromuscular junction, which can cause increased muscle weakness rather than improvement. The temporary worsening is typically characterized by symptoms such as increased muscle weakness, excessive salivation, muscle fasciculations, or respiratory distress, as these symptoms indicate overstimulation of the receptors due to high acetylcholine levels.

In contrast, an improvement in weakness would imply that the patient is responding positively to the edrophonium, suggesting a myasthenic crisis rather than a cholinergic crisis. No change in symptoms suggests that there is neither improvement nor deterioration, which is less indicative of a cholinergic crisis. An increase in muscle spasms does not align specifically with the typical presentation of a cholinergic crisis; muscle spasms might indicate a different problem or reaction.