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What are some exacerbation triggers for MG?
What is the tensilon test for?
- Reveals improved muscle contractility.
- Also aids in dx of cholinergic crisis
Myasthenia Gravis is?
Progressive autoimmune disease that produces severe muscular weakness, with periods of exacerbation and remission
Causes of MG
- Co-existing autoimmune disorder
- Strong association with hyperthyroidism
- Hyperplasia of the thymus
What is plasmapheresis?
Removal of circulating antibodies by a process thay removes antibodies from plasma
Removal of thymus
What are s/s to monitor for?
- Progressive muscle weakness
- Poor posture
- Resp compromise
For MG you are going to assess/monitor for?
- Resp status
- Swallowing ability(aspiration)
- Muscle srength
- Med hx
What are some nursing diagnosis for MG?
- Ineffective airway clearance
- Ineffective breathing patrern
- Self care deficit
- Impaired physical mobility
- Imbalanced nutrition:less than
- Impaired verbal commumication
What are some medications used for MG?
- Immunosuppressants (imuran, cytoxan & prednisone)
- IV immuniglobulins
- Cholinesterase inhibitor (mestinon- pyridostigime)
- Eat within 45min to strengthen chewing and reduce aspiration
Undermedication in MG is called? What are the characteristics?
- Myasthenia crisis
- Resp muscle weakness(mechanical ventilation)
- Myasthenic symptoms(weakness, incontinence, fatigue)
- Temporary improvement of symptoms with tensilon
What is overmedication in MG called? What are some characteristics?
- Cholinergic crisis
- Muscle twitching to the point of resp muscle weakness(mechanical ventilation)Cholinergic symptoms(hypersecretions, nausea, diarrhea, resp secretions and hpermotility[abd cramps])
- Tensilon has no positive effects, may worsen then give atropine
Muscles that are most often involved in MG?
The ones used for blinking, swallowing, speaking and breathing. These are controlled in the brainstem
How to test for muscle weakness?
Have the client loom up for 2-3 min, if the clint has MG the eyelids will start to droop. After rest client can hold eyes open again
What are the signs symptoms of MG crisis?
- B/b incontinence
- Decreased urinary out
- Absent cough or swallowing reflex
What are the s/s of cholinergic crisis?
- Abd pain
- Blurred vision
- Pupillary miosis
- Facial twitching