Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
15 Cards in this Set
- Front
- Back
|
Myasthenia Gravis
|
Sporadic, progressive neuromuscular disease characterized by a decrease in acetylcholine level at the receptor sites in the neuromuscular junction. Inadequate acetylcholine level results in a disturbance in nerve impulse transmission, causing progressive weakness in skeletal muscles.
|
|
|
Risk factors for myasthenia gravis.
|
Autoimmune disease
More common in women younger than 40 and men older than 60, but may occur at any age. |
|
|
True or false, symptoms of myasthenia gravis are predominantly bilateral?
|
True.
|
|
|
Primary problem of MG
|
Primary problem is skeletal muscle fatigue with sustained muscle contraction.
|
|
|
Clinical manifestations of Myasthenia Gravis
|
Muscular fatigue increases with activity
Ptosis ( drooping of eyelids) and diplopia are frequently the first symptoms. Impairment of facial mobility and expression Impairment of chewing and swallowing Speech impairment No sensory deficit, loss of reflexes, or muscular atrophy Poor bowel and bladder control |
|
|
Myasthenic Crisis
|
an acute exacerbation of symptoms that may require intubation and mechanical ventilation to support respiratory effort.Caused by major muscular weakness and inability to maintain respiratory function.
|
|
|
Clinical Manifestations lse and blof Myasthenic crisis
|
Severe respiratory distress and crisis
Increased pulse and BP Decreased or absent cough or swallow reflex |
|
|
Cholinergic crisis
|
A toxic response to the anticholinesterase medications; anticholinesterase medications must be withheld-this response is rare with proper dosing of Mestinon.
|
|
|
Clinical Manifestations of Cholinergic Crisis
|
n/v, diarrhea
Weakness with difficulty in swallowing, chewing, and speaking. Increased secretions and saliva Muscle fasciculation ( twitching) and constricted pupils. |
|
|
Electromyography:
|
Shows a decreasing response of muscles to stimuli.
|
|
|
Ice Pack Test
|
assess clients with ptosis; muscles improve with cold application; plack pack on closed lids for two minuets to see whether ptosis improves.
|
|
|
Tensilon Test
|
Used for diagnosing myasthenic crisis.
Used to differentiate cholingergic crisis from myasthenic crisis IV injection of neostigmine or edrophonium causes immediate, altho-lived, relief of muscle weakness. |
|
|
Treatment
|
Anticholinesterase medications
Neostigmine Pyridostigmine Corticosteriods Plasma electrophoresis. Immunosupressive therapy Surgical removal of thymus. |
|
|
Nursing Interventions.
|
Goal: To maintain respiratory function.
Asseses for increasing problems with difficulty breathing. Measure forced vital capacity frequently to assess respiratory status. Determine clients medication schedule. When was medication last taken? Assess ability to swallow; prevent problems of aspiration. Evalluate effectiveness of cough reflex Be prepared to intubate or provide ventilatory assistance. |
|
|
Administration of Tensilon
|
Myasthenic crisis: Clients condition will improve.
Cholinergic crisis: clients condition will temporarily worsen |
