Myasthenia gravis has a deficiency of what at the NEUROMUSCULAR junction?
Right Ans - Ach.
Myasthenia gravis is the autoimmune destruction of what receptors? Right
Ans - Ach.
Myasthenia gravis is an overall decrease in.. Right Ans - Neurotransmitter
available for transmission of impulses at the neuromuscular junction
What happens to the muscle in myasthenia gravis? Right Ans - Does not
receive the impulse properly
Contracts poorly or not at all
What does the autoimmune destruction do? Right Ans - Destroys or
inactivates the receptor sites on the muscle: acetylcholine receptor antibody
present in 90% of cases
What gland in involved with myasthenia gravis? Right Ans - Thymus gland
The thymus glad has... Right Ans - Undergone malignant or infectious
changes in many of these patients; it forms antibodies to attack its own
epithelial cells which also attack those in the muscles
The removal of the thymus gland happens when? Right Ans - During 1st
two years
Remission
The clinical presentation of myasthenia gravis is? Right Ans - Onset
insidious and progresses slowly; more common in women age 20-30
Progressive weakness of muscles as they are being used; after rest, function
improves
Ocular muscle weakness: most common 1st symptom in 90% of patients;
Progress of disease may stop here
, The clinical presentation as the disease progresses for myasthenia gravis is...
Right Ans - Weakness of muscles used for chewing, swallowing, and speaking;
neck muscles
Upper extremities affected before lower, proximal before distal
Eventually may involve muscles of respiration, bowel and bladder
Muscles strongest in the AM
DX of myasthenia gravis depends on.. Right Ans - History and physicals.
Classical pictures.
Myasthenia gravis is confirmed by administration of what drug? Right Ans
- Anticholinesterase drug: Tensilon
Tensilon acts within one minute Right Ans - Has a 5 min half life. So not
used for treatment
The medical treatment of myasthenia gravis is Right Ans -
Anticholinesterase drugs: block breakdown of Ach.
Anticholinesterase drugs used for myasthenia gravis Right Ans -
Prostigmine: given prior to meals; more frequent adm.
Mestinon: drug of choice d/t timed release
Crisis: both present with ↑ muscle weakness
-Myasthenic: d/t too little med
-Cholinergic: d/t too much med
To determine type of medical treatment myasthenia gravis Right Ans -
Steroids
Plasmapheresis
Thymectomy
Nursing care for myasthenia gravis Right Ans - Alteration in nutrition r/t
difficulty swallowing/chewing
Ineffective airway clearance r/t thoracic muscle weakness, ↓ coughing and
swallowing ability
Impaired gas exchange r/t muscle weakness, secretions
RF aspiration r/t cranial nerve involvement
Activity intolerance r/t muscle weakness: Organization is the key!!
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