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21 Cards in this Set
- Front
- Back
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What is Myasthenia Gravis?
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Autoimmune disease of neuromuscular junction. Antibodies attack Ach receptor sites
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This disease makes it unable to stimulate what?
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Muscle contraction leading to weakness of skeletal muscle groups
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At what age does it usually occur?
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10-65, peaks in women 20-30
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What are the s/s of the disease?
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- Fluctuating weakness of skeletal muscle
- Strength restored after resting for several hrs - Muscles strongest in AM then get exhausted with continued activity |
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What muscles are involved?
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- eyes and eyelids
- swallowing - speaking - breathing |
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What should you be concerned about with eye and eyelid involvment?
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Corneal abrasions, ptosis
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What can exacerbations be triggered by?
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- emotional stress
- pregnancy and menses - secondary illness - trauma - temp extremes - hypokalemia - medications |
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What is a Myasthenic crisis?
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Exacerbation following precipitating factors, esp. infection or failure to take drug/ dose too low
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What is the priority nursing care for someone in myasthenic crisis? What drugs are withheld?why?
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- Maintain adequate respiratory function
- Cholinesterase inhibiting drugs b/c they increase respiratory secretions |
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What is a cholinergic crisis? s/s?
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- Overdose of cholinesterase inhibiting drugs resulting in increased Ach at the receptor sites
- Ptosis, dyspnea, increased secretions, inadequate respiratory function |
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What types of medications are given to these patients?
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- Cholinesterase inhibiting drugs
- Corticosteriods - Immunosuppressant |
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What do cholinesterase inhibiting drugs do? examples?
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- Prolongs action of Ach
- Facilitates transmission of impluses - Neostigmine (Prostigmin), Pyridostigmine (Mestinon) |
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True or False
Cholinesterase inhibiting drugs do not have to be taken on a rigid time schedule. |
False, they must be given on time to maintain blood levels
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Corticosteriods and immunosuppressants do what?
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Suppresses the immune system
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Two examples of an immunosuppressant
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- Imuran
- Cytoxan |
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What is the main priority with these patients?
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RESPIRATORY
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What do you need to teach to improve nutrition?
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- Assess gag reflex, chewing and swallowing
- Frequent oral hygiene - Small, frequent meals - Encourage to eat slowly - HOB elevated during meals and 30-60 mins after - High calorie snacks |
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When should you adminster anticholinesterase drugs?
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60 mins prior to meals so they are absorbed and patient can chew and swallow
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Why are serum albumin levels monitored?
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For malnutrition
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What is the usual surgical intervention? experimental?
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- Thymectomy
- Plasmapheresis |
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If you have a patient on corticosteriods what are some things you want to watch for?
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- Hyperglycemia
- low potassium - edema - osteoporsis if long term tx |
