Prince Georges Community College Treatment of Myasthenia Gravis Case Study

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Prince Georges Community College

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Myasthenia Gravis Case Study

Please use both your pharmacology (Lehne)and adult health nursing (Lewis) textbooks for this—this will help you understand what myasthenia is and how to treat it.The Lewis text covers it on pages1393-1395 and complements what our pharm textbook covers.References and in-text citations required.Points per question in parentheses at the end of each question. (11 total points available)

J.B. is a 58-year-old retired postal worker who has been on the neurology unit for several days receiving plasmapheresis every other day for myasthenia gravis (MG).About a year ago, J.B. started experiencing difficulty chewing and swallowing, diplopia, and slurring of speech, at which time he was placed on physostigmine.Before this admission, he had been relatively stable.His medical history includes hypertension controlled with metoprolol (Lopressor) and glaucoma treated with timolol ophthalmic preparation.Recently, J.B. was diagnosed with a sinus infection and treated with ciprofloxacin (Cipro).On admission, J.B. was unable to bear any weight or take fluids through a straw.There have been periods of exacerbation and remission since admission.

Vital signs include T 101.8 degrees, HR 108, RR 24, BP 170/68

Please answer the following questions:

  • What is myasthenia gravis and what are the usual presenting symptoms (2 points)?

2) Knowing the usual presenting symptoms, what are the essential assessments for this patient with myasthenia gravis (2 points)?

3)J.B.'s wife is wondering what caused the worsening of J.B.'s symptoms at this time.What are the possible causes of the worsening of the patient’s symptoms?

4)How is myasthenia gravis diagnosed

5)Explain how each of the following is used to treat myasthenia gravis

What is plasmapharesis and why is it being used in this patient?

What is physostigmine and how does it work to treat myasthenia gravis?Why is it used and not the prototype neostigmine?

6)What emergency medication should be on hand for this patient and why (1 point)?(I am looking for an antidote to too much cholinesterase inhibitor

7)Explain the difference between myasthenic crisis and cholinergic crisis.How could the health care provider determine the difference.

*citations and references

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Explanation & Answer

Attached. Please let me know if you have any questions or need revisions.

Running head: MYASTHENIA GRAVIS CASE STUDY

Myasthenia Gravis Case Study
Student’s Name
Institution Affiliation

1

MYASTHENIA GRAVIS CASE STUDY

2

Myasthenia Gravis Case Study
Please use both your pharmacology (Lehne) and adult health nursing (Lewis) textbooks for
this—this will help you understand what myasthenia is and how to treat it. The Lewis text covers
it on pages1393-1395 and complements what our pharm textbook covers. References and in-text
citations are required. Points per question in parentheses at the end of each question. (11 total
points available)


J.B. is a 58-year-old retired postal worker who has been on the neurology unit for several
days receiving plasmapheresis every other day for myasthenia gravis.



About a year ago, J.B. started experiencing difficulty chewing and swallowing, diplopia,
and slurring of speech, at which time he was placed on physostigmine.



Before this admission, he had been relatively stable. His medical history includes
hypertension controlled with metoprolol (Lopressor) and glaucoma treated with timolol
ophthalmic preparation.



Recently, J.B. was diagnosed with a sinus infection and was treated with ciprofloxacin
(Cipro).



On admission, J.B. was unable to bear any weight or take fluids through a straw. There
have been periods of exacerbation and remission since admission.



Vital signs include T 101.8 degrees, HR 108, RR 24, BP 170/68

Please answer the following questions:

1. What is myasthenia gravis and what are the usual presenting symptoms (2 points)?
Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder that impedes joint
function and manifests as muscle weakness (Roper et al., 2017). Fluctuations in muscle

MYASTHENIA GRAVIS CASE STUDY

3

weakness are associated with conditions that include respiratory failure. According to
Statland and Ciafaloni (2013), usual presenting symptoms affiliated with Myasthenia
Gravis include weakening of skeletal muscles, difficulty in swallowing, and ocular
weakness or drooping eyes.
2. Knowing the usual presenting symptoms, what are the essential assessments for this
patient with myasthenia gravis (2 points)?
Essential assessments for JB (patient with Myasthenia Gravis) include those on the
frequency of muscle weakness upon use as well as rest. Other essential assessments that
determine the degree of severity include the test for increased fatigue as well as a
reduction in ocular strength. Assessing for cough refluxes as well as the respiratory rate
(RR) is also significant for the MG patient.
3. J.B.'s wife is wondering what caused the worsening of J.B.'s symptoms at this time.
What are the possible causes of the worsening of the patient’s symptoms?
JB was relatively stable before admission. In this case, a sinus infection is a probable
cause of the patient’s worsening condition. Prior medical examination and history is also
a prelude to possible causes of a worsening condition. Hypertension could, therefore,
explain t...


Anonymous
I was struggling with this subject, and this helped me a ton!

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