Columban College

College of Nursing Barretto, Olongapo City

A Report in Medical Surgical Nursing (NCM104C) Myasthenia Gravis Submitted to: Mam. Pinky Mae D. Barroga

Myasthenia gravis

Columban College
College of Nursing Barretto, Olongapo City

An autoimmune disorder w/c affects the myoneural junction. It is characterize by weakness of the voluntary muscles. Approximately 60,000 people have Myasthenia Gravis in the U.S. and women are more frequently affected by men, and they tend to develop at an earlier age(20-40years vs. the 60-70years of men.)

Pathophysiology In myasthenia gravis, antibodies directed at the acetylcholine receptor sites impair transmission of impulses across the myoneural junction. Therefore fewer receptors are available for stimulation, resulting in voluntary muscle weakness. Clinical Manifestations Diplopia(double vision) Ptosis(Drooping of Eyelids) Dysphonia(Voice Impairment)

Assessment and Diagnostic Findings Acetylcholinesterase inhibitor test Endorphium Chloride (Tensilon) administered through IV to Diagnose myasthenia gravis immediate improvement of muscle weakness after administration of this drug represent a positive result in the diagnosis MRI EMG(electromyography)

Medical Management Management is directed at improving and reducing and removing circulating antibodies. Thymectomy(thymus Removal)

Columban College
College of Nursing Barretto, Olongapo City

*there is no cure for myasthenia gravis; Treatments do not stop the production of the acetylcholine receptor antibodies. Pharmacologic Therapy Administration of Anticholinesterase Medication

-Pyridostigmine bromide (Mestinon) an anticolnesterase medication it provides symptomatic relief by inhibiting the breakdown of acetylcholine and increasing relative concentration of available acetylcholine at the neuromuscular junction. Corticosteroids are also used Administration of cytotoxic drugs(Azathioprine(Imuran)) Intravenous Globulin is used to treat exacerbations in selected patients. Plasmapharesis(plasma exchange) -A technique that is used to treat exacerbations the patients plasma and plasma components are removed through a centrally large-bore double lumen catheter. Surgical Management Thymectomy -The Thymus is removed to produce antigen-specific immunosuppression and result in clinical improvement. The procedure done is either partial or complete remission. Complications Respiratory Failure Myasthenic Crisis(Respiratory Distress, Dysphagia, Dysarthia, eyelid ptosis, diplopia, and prominent muscle weakness)

Columban College
College of Nursing Barretto, Olongapo City

Nursing Management Ensure Medication Administration Minimize Risk of Aspiration