Myasthenia Gravis

Question 1

Myasethenia Gravis - Patho

Answer 1

• Autoimmune disorder affecting myoneural junction
  > Acetylcholine receptor sites impair transmission
  > dcrd receptor stimulation
  > muscle weakness escalates w/ continued activity
  > women greater than men
  > 75% thymus gland issue

Question 2

Myasthenia Gravis - CMs

Answer 2

• Diplopia/ptosis (80%)
• Face & throat muscle weakness
• Dysphonia
• Dysphagia
  > incr risk aspiration
• Generalized weakness
• Pure motor; no sensory involvement

Question 3

Myasthenia Gravis - Diagnostics

Answer 3

• Acetylcholinesterase inhibitor test
• Lab: acetylcholine antibodies
• Ice test
  > hold ice over affected area, symps improve for a short time
• Repetitive nerve stimulation
  > will weaken tht area
  keep antidote around: Atropine

Question 4

Myasthenia Gravis - Medical Surgical Treatment

Answer 4

• Pharmacologic therapy: Pyridostigmine
  > incring concentration of available acetylcholine 4x/day
  > take 45-60 mins before meals
• Therapeutic plasma exchange
  > plasmapheresis
• Surgical management
  > thymectomy

Question 5

Myasthenia Gravis - Nursing Diagnosis

Answer 5

• Ineffective airway clearance
• Interrupted family process
• Fatigue
• Impaired phsyical mobility
• Imbalanced nutrition
• Impaired swallowing

Question 6

Myasthenia Gravis - Nursing Interventions

Answer 6

• Conserve energy
  > consistent routines
  > avoid excessive activity/stress
  > high envir’t temp
• Med prior to meals
  > prevent aspiration
• Tape eye closed/eye drops
  > prevent corneal damage