Evolve Questions Myasthenia gravis Flashcards

A thymectomy accomplished via a median sternotomy approach is performed in a client with a diagnosis of myasthenia gravis. The nurse creates a postoperative plan of care for the client that would include which intervention?

1.Monitor the chest tube drainage.

2.Restrict visitors for 24 hours postoperatively.

3.Maintain intravenous infusion of lactated Ringer's solution.

4.Avoid administering pain medication to prevent respiratory depression.

A client with myasthenia gravis is having difficulty with airway clearance and difficulty with maintaining an effective breathing pattern. The nurse would keep which most important items available at the client's bedside?

1.Oxygen and metered-dose inhaler

2.Ambu bag and suction equipment

3.Pulse oximeter and cardiac monitor

4.Incentive spirometer and cough pillow

The home health nurse is visiting a client with myasthenia gravis and is discussing methods to minimize the risk of aspiration during meals related to decreased muscle strength. Which suggestions would the nurse give to the client? Select all that apply.

1.Chew food thoroughly.

2.Cut food into very small pieces.

3.Lift the head while swallowing liquids.

4.Sit straight up in the chair while eating.

5.Swallow when the chin is tipped slightly downward to the chest.

The nurse has instructed a client with myasthenia gravis about strategies for self-management at home. The nurse determines a need for further teaching if the client makes which statement?

1."Here's the MedicAlert bracelet I obtained."

2."I need to take my medications an hour before mealtime."

3."Going to the beach will be a nice, relaxing form of activity."

4."I've made arrangements to get a portable resuscitation bag and home suction equipment."

The nurse has provided instructions to a client with a diagnosis of myasthenia gravis about home care measures. Which client statement indicates the need for further teaching?

1."I will rest each afternoon after my walk."

2."I should cough and deep-breathe many times during the day."

3."I can change the time of my medication on the mornings when I feel strong."

4."If I get abdominal cramps and diarrhea, I should call my health care provider."

A client with myasthenia gravis arrives at the hospital emergency department in suspected crisis. The primary health care provider plans to administer edrophonium to differentiate between myasthenic and cholinergic crises. The nurse ensures that which medication is available in the event that the client is in cholinergic crisis?

1.Atropine sulfate

2.Morphine sulfate

3.Protamine sulfate

4.Pyridostigmine bromide

A client with a history of myasthenia gravis presents at a clinic with bilateral ptosis and is drooling, and myasthenic crisis is suspected. The nurse assesses the client for which precipitating factor?

1.Getting too little exercise

2.Taking excess medication

3.Omitting doses of medication

4.Increasing intake of fatty foods

The nurse is providing information to a client with myasthenia gravis who is scheduled for an electromyogram. Which statement by the client indicates the teaching has been effective?

1."An informed consent form is not required."

2."Needles will be inserted into the skeletal muscles."

3."Medication is injected into the nerve for stimulation."

4."Nothing by mouth status must be maintained for 12 hours before the test."

The nurse who is caring for a client with myasthenia gravis is told by the physician that an edrophonium test will be done. After obtaining edrophonium the nurse would be certain that which also is available at the bedside?

1.Atropine sulfate

2.Protamine sulfate

3.Calcium gluconate

4.Magnesium sulfate

The nurse is caring for a client with myasthenia gravis who has received edrophonium by the intravenous route to test for myasthenic crisis. The client asks the nurse how long the improvement in muscle strength will last. Which response would the nurse make to the client?

1."It will last for 4 to 5 minutes."

2."It will last for about 30 minutes."

3."It will last longer than 60 minutes."

4."It will last approximately 10 minutes."

A client with myasthenia gravis has difficulty chewing and has received a prescription for pyridostigmine. The nurse would check to see that the client takes the medication at what time?

1.With meals

2.Between meals

3.Just after meals

4.30 minutes before meals

A client with myasthenia gravis who is taking neostigmine is experiencing frequent exacerbations of myasthenic crisis and cholinergic crisis. The nurse teaches the client that it is most important that this medication be taken in which manner?

1.On time

2.On an empty stomach

3.Double-dosed if one dose is missed

4.Titrated for dosage, depending on symptoms

The primary health care provider is preparing to administer edrophonium to the client with myasthenia gravis. In planning care, the nurse understands which about the administration of edrophonium? Select all that apply.

1.Edrophonium is a long-acting cholinesterase inhibitor.

2.Atropine is used to reverse the effects of edrophonium.

3.If symptoms worsen following administration of edrophonium, the crisis is cholinergic.

4.Edrophonium is used to distinguish between a myasthenic crisis and a cholinergic crisis.

5.An improvement in symptoms following administration of edrophonium indicates myasthenic crisis.

A client is suspected of having myasthenia gravis. Edrophonium is administered intravenously to determine the diagnosis. Which indicates that the client may have myasthenia gravis?

1.Joint pain following administration of the medication

2.Feelings of faintness, dizziness, hypotension, and signs of flushing in the client

3.A decrease in muscle strength within 30 to 60 seconds following administration of the medication

4.An increase in muscle strength within 30 to 60 seconds following administration of the medication

The nurse is assisting in the care of a client who is being evaluated for possible myasthenia gravis. The primary health care provider gives a test dose of edrophonium. Evaluation of the results indicates that the test is positive. Which would be the expected response noted by the nurse?

1.Joint pain for the next 15 minutes

2.An immediate increase in blood pressure

3.An increase in muscle strength within 1 to 3 minutes

4.Feelings of faintness or dizziness for 5 to 10 minutes

The nurse is assisting in the care of a client with myasthenia gravis who is receiving pyridostigmine. Which medication would the nurse plan to have readily available should the client develop cholinergic crisis because of excessive medication dosage?

1.Vitamin K

2.Acetylcysteine

3.Atropine sulfate

4.Protamine sulfate

A client with myasthenia gravis becomes increasingly weaker. The primary health care provider injects a dose of edrophonium to determine whether the client is experiencing a myasthenic crisis or a cholinergic crisis. The nurse expects that the client will have which reaction if in cholinergic crisis?

1.No change in the condition

2.Complaints of muscle spasms

3.An improvement of the weakness

4.A temporary worsening of the condition

The nurse is teaching a client with myasthenia gravis about the prevention of myasthenic and cholinergic crises. Which client activity suggests that teaching is most effective?

1.Taking medications as scheduled

2.Eating large, well-balanced meals

3.Doing muscle-strengthening exercises

4.Doing all chores early in the day while less fatigued

A client with myasthenia gravis has become increasingly weaker. The primary health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which finding would indicate that the client is in cholinergic crisis?

1.No change in the condition

2.Complaints of muscle spasms

3.An improvement of the weakness

4.A temporary worsening of the condition