The client is diagnosed with MG. Which intervention
should the nurse implement when administering the
anticholinesterase pyridostigmine (Mestinon)?
1. Assess for excess salivation and abdominal cramps.
2. Administer the medication before the client has eaten.
3. Break the capsule and sprinkle the medication on the food.
4. Assess the client's potassium level prior to
administering medication. ✔️Correct answer 1:
Anticholinesterase medications can cause the client to have excessive
salivation and abdominal cramping. When this occurs, the client receives the
antidote atropine simultaneously in small doses. Mestinon is administered
with milk and/or crackers to prevent stomach upset. Mestinon
does not affect potassium levels.
The male client diagnosed with MG is prescribed the
cholinesterase inhibitor neostigmine (Prostigmin). Which
data indicate the medication is not effective?
1. The client is able to perform activities of daily
living (ADLs) independently.
2. The client states that his vision is clear.
3. The client cannot speak or look upward at the
ceiling.
4. The client is smiling and laughing with the nurse. ✔️Correct answer 3:
Dysphonia and inability to utilize the muscles of the eye and eyelid indicate
the medication is not effective. Performing ADLs, having clear vision, and
smiling and laughing using the facial muscles indicate the medication is
effective
The client diagnosed with MG is admitted to the
emergency department with a sudden exacerbation of motor weakness.
Which assessment data indicate the client is experiencing a myasthenic crisis?
, 1. The serum assay of circulating acetylcholine
receptor antibodies is increased.
2. The client's symptoms improve when
administering on a cholinesterase inhibitor.
3. The client's blood pressure, pulse, and respirations improve after
intravenous (IV) fluid.
4. The Tensilon test does not show improvement in the client's muscle
strength ✔️Correct answer 2:
This assessment datum indicates a myasthenic crisis that is due to
undermedication, missed doses of medication, or developing an infection.
Serum assays are useful in diagnosing the disease, not in identifying a crisis.
Vital signs do not differentiate the type of crisis. No improvement after
Tensilon indicates a cholinergic crisis, not a
myasthenic crisis.
Which statement by the 20-year-old female client diagnosed with MG
indicates the client understands the discharge teaching?
1. "I can have children, but I will have to see my
neurologist during my pregnancy."
2. "I have a new job at a children's day care center to help with expenses."
3. "I should not take a bath because I could pass out and drown while in the
tub."
4. "I will drink at least 1000 mL of water or other
liquid every day." ✔️Correct answer 1:
MG will not prevent conception or delivery but can cause the client to
experience an exacerbation of the disease. The client should be seen regularly
by the neurologist and the obstetrician. Young children are ill frequently, and
infections
can result in an exacerbation for the client. Option 3 applies to clients who
have seizures. The client is not restricted to 1000 mL of fluid per day.
The male client with MG is undergoing plasmapheresis at the bedside. Which
assessment data would warrant immediate intervention by the nurse?
1. The client complains of being lightheaded and dizzy.
2. The client can smile and clamp his teeth together.
3. The client states that his leg cramps have gone away.
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