Myasthenia gravis (MG) is the most common primary disorder of neuromuscular transmission. Myasthenia Gravis is a type of autoimmune disorder, a neuromuscular disease that usually results to muscle weakness and fatigue primarily in the face. This makes the muscles get tired and weakened more easily than what is normal.
The usual cause is an acquired immunological abnormality, but some cases result from genetic abnormalities at the neuromuscular junction. Much has been learned about the pathophysiology and immunopathology of myasthenia gravis during the past 20 years.
This is often manifested whenever a person suffering from this disorder tries to eat. Within a few minutes of chewing and swallowing, his muscles weaken and get tired, making it hard or even impossible to finish his meal. Often, a few minutes of rest will restore the muscles and the person can continue finishing his meal.
The symptoms of myasthenia gravis include:
- Droopy eyelids (ptosis)
- Double vision (diplopia)
- Difficulty swallowing (dysphagia) with an increased risk of gagging and choking
- Change in the quality of one's voice
- Increasing weakness of a particular muscle group during continuous use of those muscles
- Improved strength of muscles after resting those muscle groups
- Weak cough
- Difficulty breathing, leading to respiratory failure (myasthenic crisis)
Nursing Diagnosis and Interventions for Myasthenia Gravis:
1. Impaired gas exchange related to respiratory muscle weakness
Purpose:
Patient will maintain adequate gas exchange:
Interventions:
1. Approach to the client, with communication alternatives, if the client is using a ventilator.
2. Note the oxygenation saturation, with oximetry, especially with activity.
3. Measure respiratory parameters regularly.
4. Collaboration with physicians to anticholinergic medication.
5. Sucktion as required anticholinergic drugs increased bronchial secretion).
2. Self-care deficit related to muscle weakness, general fatigue
purpose:
Patients will be able to do at least 25% of the activities themselves and dress up.
Interventions:
1. Create maintenance schedule to the interval.
2. Give the patient a break in between events.
3. Perform self-care for the patient during a very excessive muscle weakness or include family.
4. Demonstrate energy saving techniques
3. Imbalanced Nutrition Less Than Body Requirements related to dysphagia, intubation, or muscle paralysis.
Purpose:
Caloric intake will be adequate to meet the metabolic needs
Interventions :
1. Assess reflex cough reflex and swallowing disorders before administration by mouth.
2. Stop feeding by mouth if the patient is unable to cope with oral secretions or if the cough reflex swallowing disorders or depressed.
3. Replace the hose and give small meals eaten per-interval if there dysfagia.
4. Record intake and output.
5. Perform nutritional consultation to evaluate calories.
6. Measure the patient's body weight every day.