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21 Cards in this Set

  • Front
  • Back
What is Myasthenia Gravis?
Autoimmune disease of neuromuscular junction. Antibodies attack Ach receptor sites
This disease makes it unable to stimulate what?
Muscle contraction leading to weakness of skeletal muscle groups
At what age does it usually occur?
10-65, peaks in women 20-30
What are the s/s of the disease?
- Fluctuating weakness of skeletal muscle
- Strength restored after resting for several hrs
- Muscles strongest in AM then get exhausted with continued activity
What muscles are involved?
- eyes and eyelids
- swallowing
- speaking
- breathing
What should you be concerned about with eye and eyelid involvment?
Corneal abrasions, ptosis
What can exacerbations be triggered by?
- emotional stress
- pregnancy and menses
- secondary illness
- trauma
- temp extremes
- hypokalemia
- medications
What is a Myasthenic crisis?
Exacerbation following precipitating factors, esp. infection or failure to take drug/ dose too low
What is the priority nursing care for someone in myasthenic crisis? What drugs are withheld?why?
- Maintain adequate respiratory function
- Cholinesterase inhibiting drugs b/c they increase respiratory secretions
What is a cholinergic crisis? s/s?
- Overdose of cholinesterase inhibiting drugs resulting in increased Ach at the receptor sites
- Ptosis, dyspnea, increased secretions, inadequate respiratory function
What types of medications are given to these patients?
- Cholinesterase inhibiting drugs
- Corticosteriods
- Immunosuppressant
What do cholinesterase inhibiting drugs do? examples?
- Prolongs action of Ach
- Facilitates transmission of impluses
- Neostigmine (Prostigmin), Pyridostigmine (Mestinon)
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
Corticosteriods and immunosuppressants do what?
Suppresses the immune system
Two examples of an immunosuppressant
- Imuran
- Cytoxan
What is the main priority with these patients?
RESPIRATORY
What do you need to teach to improve nutrition?
- 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
When should you adminster anticholinesterase drugs?
60 mins prior to meals so they are absorbed and patient can chew and swallow
Why are serum albumin levels monitored?
For malnutrition
What is the usual surgical intervention? experimental?
- Thymectomy
- Plasmapheresis
If you have a patient on corticosteriods what are some things you want to watch for?
- Hyperglycemia
- low potassium
- edema
- osteoporsis if long term tx