Podcast
Questions and Answers
Why is it important for the nurse to check swallowing before giving medications?
Why is it important for the nurse to check swallowing before giving medications?
- To prevent aspiration (correct)
- To monitor for facial appearance changes
- To evaluate vision changes
- To assess arm and leg strength
What is a common sign that a patient with myasthenia gravis may experience in their vision?
What is a common sign that a patient with myasthenia gravis may experience in their vision?
- Tunnel vision
- Blurred vision (correct)
- Night blindness
- Color blindness
Why should smaller meals that are easy to chew be recommended for patients with myasthenia gravis?
Why should smaller meals that are easy to chew be recommended for patients with myasthenia gravis?
- To minimize effort in chewing (correct)
- To allow for quicker eating times
- To increase their appetite
- To improve digestion
Why is it suggested to schedule meals during the peak time of medication for patients with myasthenia gravis?
Why is it suggested to schedule meals during the peak time of medication for patients with myasthenia gravis?
What is a potential consequence of not educating a patient with myasthenia gravis to take small bites and rest while eating?
What is a potential consequence of not educating a patient with myasthenia gravis to take small bites and rest while eating?
Why should large meals be preferred at the beginning of the day for patients with myasthenia gravis?
Why should large meals be preferred at the beginning of the day for patients with myasthenia gravis?
Which symptom of Myasthenia Gravis involves the patient experiencing eyelid drooping in one or both eyes?
Which symptom of Myasthenia Gravis involves the patient experiencing eyelid drooping in one or both eyes?
What is a common sign of Myasthenia Gravis where the patient's face appears mask-like and lacks expression?
What is a common sign of Myasthenia Gravis where the patient's face appears mask-like and lacks expression?
What diagnostic test for Myasthenia Gravis involves administering a medication called Edrophonium?
What diagnostic test for Myasthenia Gravis involves administering a medication called Edrophonium?
Which complication of Myasthenia Gravis may require intubation and mechanical ventilation for the patient to breathe?
Which complication of Myasthenia Gravis may require intubation and mechanical ventilation for the patient to breathe?
What risk factor can lead to a severe acute exacerbation in Myasthenia Gravis patients known as Myasthenic Crisis?
What risk factor can lead to a severe acute exacerbation in Myasthenia Gravis patients known as Myasthenic Crisis?
Which symptom of Myasthenia Gravis involves the patient having a hoarse and very soft voice?
Which symptom of Myasthenia Gravis involves the patient having a hoarse and very soft voice?
Which of the following signs or symptoms is NOT commonly seen in myasthenia gravis?
Which of the following signs or symptoms is NOT commonly seen in myasthenia gravis?
What is a characteristic visual symptom experienced by individuals with myasthenia gravis?
What is a characteristic visual symptom experienced by individuals with myasthenia gravis?
Which of the following treatments is a common intervention for myasthenia gravis?
Which of the following treatments is a common intervention for myasthenia gravis?
What type of medication is typically used to manage myasthenia gravis?
What type of medication is typically used to manage myasthenia gravis?
When is the best time to assist a patient with myasthenia gravis in bathing and exercising?
When is the best time to assist a patient with myasthenia gravis in bathing and exercising?
Which of the following activities would be most challenging for a patient with myasthenia gravis?
Which of the following activities would be most challenging for a patient with myasthenia gravis?
What is the primary function of the anticholinesterase medication Pyridostigmine in treating Myasthenia Gravis?
What is the primary function of the anticholinesterase medication Pyridostigmine in treating Myasthenia Gravis?
When should a patient with Myasthenia Gravis take their anticholinesterase medication for optimal results?
When should a patient with Myasthenia Gravis take their anticholinesterase medication for optimal results?
Which of the following is NOT a common side effect of a cholinergic crisis?
Which of the following is NOT a common side effect of a cholinergic crisis?
What is the primary difference between a myasthenic crisis and a cholinergic crisis in a patient with Myasthenia Gravis?
What is the primary difference between a myasthenic crisis and a cholinergic crisis in a patient with Myasthenia Gravis?
How should a cholinergic crisis be treated in a patient with Myasthenia Gravis?
How should a cholinergic crisis be treated in a patient with Myasthenia Gravis?
What are some factors that can worsen the symptoms of Myasthenia Gravis?
What are some factors that can worsen the symptoms of Myasthenia Gravis?
Where is the thymus gland located in the human body?
Where is the thymus gland located in the human body?
What is the most appropriate time to administer Pyridostigmine to a patient with myasthenia gravis who is eating lunch at 1200?
What is the most appropriate time to administer Pyridostigmine to a patient with myasthenia gravis who is eating lunch at 1200?
What is the primary function of Pyridostigmine in treating myasthenia gravis?
What is the primary function of Pyridostigmine in treating myasthenia gravis?
Which type of receptors are damaged in a patient with myasthenia gravis?
Which type of receptors are damaged in a patient with myasthenia gravis?
What is the main reason for administering Pyridostigmine 1 hour before a patient with myasthenia gravis eats?
What is the main reason for administering Pyridostigmine 1 hour before a patient with myasthenia gravis eats?
How does Pyridostigmine improve muscle strength in patients with myasthenia gravis?
How does Pyridostigmine improve muscle strength in patients with myasthenia gravis?
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Study Notes
Monitoring Neuromuscular Status
- Assess vision, voice, swallowing, facial appearance, strength in arms and legs, and cranial nerves to monitor neuromuscular status in patients with Myasthenia Gravis (MG)
- Patients are at risk of injury and require assistance at all times
- Speech pathologists will evaluate and recommend treatment based on findings
Safety Precautions
- Patients may have double vision and require an eye patch to help
- Arm and leg weakness is common
- Patients are at risk of aspiration and require hob of greater than 30' while eating
- Feeding tubes may be necessary, and nurses will manage them
Nutrition and Swallowing
- Patients may have difficulty chewing and swallowing due to weakened muscles
- Recommend small, easy-to-chew meals that require minimal effort
- Schedule meals during peak medication time (30 minutes to 1 hour before eating)
- Thicken liquids to aid swallowing
- Take small bites and rest while eating
- Large meals should be consumed early in the day when energy levels are highest
Signs and Symptoms of Myasthenia Gravis
- Weakness in neck, face, arms, legs, and hands
- Eyelid drooping (Ptosis) or double vision (Strabismus)
- Mask-like appearance with no expression, looking sleepy
- Difficulty swallowing due to weak muscles
- No energy, with fatigue worsening throughout the day
- Slurred speech, shortness of breath, and respiratory failure are possible complications
Complications of Myasthenia Gravis
- Myasthenic Crisis: a severe acute exacerbation of MG, requiring intubation and mechanical ventilation
- Risk factors include improper medication dosage, stress, and respiratory infection
- Patients may experience severe weakness, respiratory failure, and require intubation
Diagnosis and Treatment
- Edrophonium (Tensilon) test diagnoses MG by preventing acetylcholine breakdown, allowing more neurotransmitter at the neuromuscular junction
- Anticholinesterase medications (e.g., Pyridostigmine) improve symptoms by preventing acetylcholine breakdown, increasing muscle strength
- Thymectomy, corticosteroids, and plasmapheresis are treatment options, but not cholinesterase medications
- Pyridostigmine should be taken 30-60 minutes before a meal to aid swallowing and chewing
- Monitor for Myasthenic crisis (from not enough medication) or cholinergic crisis (from too much medication), both causing respiratory failure and severe muscle weakness
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