Describe a myasthenic crisis

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Assignment:

D.S. Is a 74-year-old retired social worker who has been on your floor for several days receiving q.o.d. plasmapheresis for myasthenia gravis (MG). She has a PMH of type 2 DM for 3 years and low back pain secondary to spinal stenosis. She received 2 steroid injections into her spine for pain 2 to 3 weeks before her admission, which was followed by progressive, symmetric, weakness in her lower extremities proximal > distal; R foot numbness; poor eye-hand coordination; and significant hand weakness. On admission, D.S. was unable to bear any weight of take fluids through a straw. There have been periods of exacerbation and remission since admission.

1. You are visiting with D.S.s grandson who tells you he is just starting medical school and he would like to know more about MG so that he can discuss it with his grandmother. What do you tell him?

2. He asks you to explain how plasmapheresis works. How would you explain this treatment?

3. He asks what drugs are used to treat MG. You explain although neostigmine (prostigmin) and pyridostigminbe (Mestinin) are often used in combination, drug regimens and doses are highly individualized. Identify the appropriate drug classification and explain the action of these two drugs to D.S.s grandson.

4. D.S. told her grandson that after taking her morning medications, she often experienced nausea, heartburn, slight SOB, sweating, and she felt her heart beating rapidly. What can you tell him about this?

5. Describe a myasthenic crisis.

6. List six nursing problem statements that would be appropriate for D.S.

7. List five factors that could predispose D.S. to an exacerbation of her illness.

8. D.S. Asks you what the doctors meant when they were talking about some kind of a challenge test. You realize they must have been discussing the possibility of performing an edrophonium (Tensilon) challenge. What is a Tensilon challenge, and what information will it yield>

9. What are aminoglycosides, and why are they contraindicated in patients with MG?

10. D.S.s grandson wants to know when shell be able to go home. How do you respond?

11. What supportive measures can you suggest to D.S.s grandson that he can undertake or arrange on behalf of his grandmother?

Reference no: EM133988407

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