Chronic autoimmune neuromuscular disorder affecting the neurumuscular joint. It is purely a MOTOR Disorder with no effect on sensation or coordination.
- characterized by fatigue and severe weakness of skeletal muscles.
- occurs with remissions and exacerbations.
- occurs more frequently in females, with onset between ages 20-30
- Ptosis (drooping of eyelids), Diplopia (double vision)
- weakness in mouth muscles resulting in dysarthria and dysplagia
- weak voice, smile appears as snarl.
- muscles are weak but DTRs are normal
Pneumonia
Myasthenic crisis
- Sudden exacerbation of motor weakness putting client at risk for respiratory failure and aspiration
- Manifestation: tachycardia, tachypnea, respiratory distress, dysphasia
- Occurs with overdosage of medications (anticholinesterase drugs) used to treat MG
- Develops GI symptoms, severe muscle weakness, vertigo and respiratory distress
- physical examination and history
- Tensilon Test: edrophonium chloride administered and client with myasthenia will show significant improvement lasting 5mins.
- EMG: reduced action potential
- Antiacetylcholine receptor antibody serum levels; increased in 80% MG clients; used to follow course of treatment
- Serum assay of circulating acetylcholine receptor antibodies
- Anticholinesterase medications [pyridostigmine bromide 'Mestinon']
- Immunsuppression medications including glucocorticiods (cyclosporineor azathioprine 'Imuran')
- Teaching interventions to deal with fatigue
- Importance of following medication therapy
- Ineffective airway clearance
- Impaired swallowing: plan to take medication to assist with chewing activity
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