What indicates the therapeutic effect of neostigmine bromide in a client with myasthenia gravis?

Neostigmine bromide is a medication that inhibits the enzyme acetylcholinesterase, leading to an increase in the level of acetylcholine at the neuromuscular junction. In the context of myasthenia gravis, a condition characterized by weakness due to the body’s immune response against acetylcholine receptors, the therapeutic effect of neostigmine is primarily observed in the improvement of muscle strength.

Improved swallowing function is a key indicator of therapeutic effectiveness because myasthenia gravis often affects the muscles involved in swallowing. By enhancing neuromuscular transmission, neostigmine helps restore normal function in affected muscles, resulting in the client's ability to swallow more effectively.

While bradycardia and decreased blood pressure may be side effects of neostigmine, they do not directly reflect an improvement in muscle function or symptom relief. An increased heart rate is not indicative of the drug's therapeutic effect in myasthenia gravis and does not relate to the primary purpose of addressing muscle weakness. Therefore, the correct choice reflects a key functional improvement that is relevant to the management of myasthenia gravis symptoms.