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What are some exacerbation triggers for MG?
- Infection
- Stress
- Fatigue
- Heat
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What is the tensilon test for?
- Reveals improved muscle contractility.
- Also aids in dx of cholinergic crisis
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Myasthenia Gravis is?
Progressive autoimmune disease that produces severe muscular weakness, with periods of exacerbation and remission
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Causes of MG
- Co-existing autoimmune disorder
- Strong association with hyperthyroidism
- Hyperplasia of the thymus
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What is plasmapheresis?
Removal of circulating antibodies by a process thay removes antibodies from plasma
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Thymectomy
Removal of thymus
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What are s/s to monitor for?
- Progressive muscle weakness
- Poor posture
- Ptosis
- Dysphagia
- Diplopia
- Resp compromise
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For MG you are going to assess/monitor for?
- Resp status
- Swallowing ability(aspiration)
- Muscle srength
- Med hx
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What are some nursing diagnosis for MG?
- Ineffective airway clearance
- Ineffective breathing patrern
- Self care deficit
- Impaired physical mobility
- Imbalanced nutrition:less than
- Constipatiob
- Impaired verbal commumication
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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
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Undermedication in MG is called? What are the characteristics?
- Myasthenia crisis
- Resp muscle weakness(mechanical ventilation)
- Myasthenic symptoms(weakness, incontinence, fatigue)
- HTN
- Temporary improvement of symptoms with tensilon
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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])
- Hypotension
- Tensilon has no positive effects, may worsen then give atropine
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Muscles that are most often involved in MG?
The ones used for blinking, swallowing, speaking and breathing. These are controlled in the brainstem
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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
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What are the signs symptoms of MG crisis?
- Tachycardia
- Tachypnea
- HTN
- Cyanosis
- Anoxia
- B/b incontinence
- Decreased urinary out
- Absent cough or swallowing reflex
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What are the s/s of cholinergic crisis?
- N/v
- Diarrhea
- Abd pain
- Pallor
- Blurred vision
- Hypotension
- Pupillary miosis
- Facial twitching
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