Topic 11: Myasthenia Gravis Flashcards
myasthenia gravis (MG)
autoimmune disease of the neuromuscular junction marked by fluctuating weakness of certain skeletal muscle groups. Antibodies attach the Ach receptors
clinical manifestation of MG
· Ptosis (drooping of the eyelid)
· Double vision
· Facial mobility and expression may be impaired
· Difficulty chewing and swallowing food
· Fluctuating weakness of skeletal muscles
Muscles often include those used to move eyes, and eyelids, chew, swallow
when are muscles generally strongest for MG
STRONGEST IN THE MORNING and become exhausted with continued activity
what restores strength in MG
period of rest
Myasthenic crisis
· Triggered by respiratory infection, surgery, emotional distress, pregnancy, exposure to certain drugs, or beginning treatment with corticosteroids
· Affects swallowing and breathing
Results in aspiration, respiratory insufficiency, or respiratory tract infection
diagnosis of MG
Response to TENSION TEST can indicate MG
· If muscle strength has improvement in muscle strength after IV injection of edrophonium (Tensilon), it indicates MG
antidote for edrophonium (Tensilon)
Atropine
what enlarged gland can cause MG
thymus
nursing implementation for MG
· Maintain adequate ventilation (since hospitalization is usually due to respiratory tract infection
· Monitor for myasthenic crisis vs cholinergic crisis
· Teach patient about a diet that can be easily chewed and swallowed (semi-solid)
· Schedule doses of drugs so peak times are around mealtime
nutrition for MG
· Teach patient about a diet that can be easily chewed and swallowed (semi-solid)
· Schedule doses of drugs so peak times are around mealtime
surgical therapy for MG
Because the thymus gland appears to enhance the production of Ach antibodies, thymectomy may occur
drugs for MG
Anticholinesterase drugs
Corticosteroids
Immunosuppressants
pyridostigmine
anticholinesterase; best for long-term
