N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Nursing interventions for myasthenia gravis: • Continue to monitor respiratory effort, vital signs, and neurological status • Provide support with nutritional intake: o Order appropriate diet: pureed, mechanical, and soft tube feedings per MDorder o Offer assistance with tray setup, hand washing, and feeding o Consult with dietary department and dietician for appropriatediet o Consult with speech therapy for chewing and swallowingevaluation o Ensure adequate caloric intake for patient’s weight; monitor weightmonthly • Give medications to provide relief of symptoms and progression ofdisease: o Mestinon (pyridostigmine bromide): Helps to improve muscle strength. This medication works best when taken 45 minutes prior to meals to aid chewing and swallowing. Side effects include GI upset, increased salivation, miosis, and muscle weakness. o Prostigmin (neostigmine): Improves the nervous system transmissions to the muscles. Side effects include drowsiness, GI upset, and urinary frequency. This medicine may be taken with or without food. o Atropine: This medication can be used in case of overdose of the above medications. o Corticosteroids (Prednisone, Solu-Medrol): Can help to reduce the antibodies found in MG. o Plasmaphereses: Exchanging plasma can help reduce antibodies found in MG. • Support surgical care if physician decides to remove thymus gland. This procedure can assist with remission induction in this disease. • Assist with communication: give patient time to speak, offer whiteboard to write needs, and consult speech therapist • Encourage frequent rest periods and pace activities; provide assistance withambulation • Refer patient to support groups or activity based programs for patients withthis disease • Assist with finding home health for support with ADLs, shopping, and physician appointments Expected outcomes for myasthenia gravis: • Increased activity tolerance and ability to perform ADLs • Maintains adequate nutritional intake and weight • Demonstrates medication compliance • Demonstrates effective respirations • Demonstrates adequate muscle strength • Verbalizes understanding of disease and care management ©2017 Achieve Test Prep Page 86 of 204