Nursing Intervention for Myasthenia Gravis

Intervention and Implementation for Myasthenia Gravis

Monitoring

1. Monitor respiratory status of patients to see the possibility of respiratory failure and myasthenic or cholinergic crisis.


2. Watch for signs of a crisis that threatens :
   • Sudden respiratory distress
   • The signs of dysphagia, ptosis and diplobia
   • Tachycardia, anxiety.
   
   
3. Monitor the patient's response to drug therapy

Nursing Actions

1. Give the medication so that its peak effects along with food and essential activity.


2. Help the patient make a realistic schedule of activities.


3. Provide rest periods to minimize fatigue.


4. Provide tools to help patients perform daily activities despite the weakness.


5. If the patient has diplopia given blindfolds to use the other eye to minimize the risk of falling.


6. To avoid aspiration:
   • Teach the patient to position the head slightly flexed position to protect the airway while eating
   • Provide a vacuum so that the patient can operate it
   • If the patient is in crisis or experiencing swallowing disorders given iv fluids and eating through a tube nasogastrik, elevate the head of the bed after feeding.
   • If the patient is taking mechanical ventilators provide suction that often, review and check for breath sounds, report the results of chest X-rays.
   
   
7. Show the patient how to hold his chin with his hand to prop up the lower jaw to help talk.


8. If the patient is speaking with very severely disturbed encourage patients to use alternative communication methods such as flash cards or board letter.

Education and Health Care

1. Instruct patients and families associated with symptoms of myasthenia crisis.


2. Teach the patient ways to prevent a crisis and a worsening of symptoms ;
   • Avoid exposure to colds and other infections
   
   
   • Avoid excessive heat or cold
   
   
   • Tell the patient to inform the dentist about the condition, because the use of procaine (navokaine) are not well tolerated and may spark crisis
   • Avoid emotional distress
   
   
3. Teach the patient and family associated with the use of suction house


4. Revisit the height of the drug and how to schedule mendapatakn akifitas for good results.


5. Emphasize the importance of scheduled rest periods to avoid fatigue.


6. Instruct the patient to wear a medical alert bracelet.

Nursing Care Plan : Assessment and Diagnosis for Myasthenia Gravis