Myaesthenia Gravis

     Myaesthenia Gravis (MG) is a common disorder to the neuromuscular junction. It is an autoimmune disorder that weakness the skeletal muscle and leads to fatigue. The disease has a fatigable faintness that involves ocular muscles and the patients develop weakness in the bulbar or limb for the period of the first three years of the symptoms. There are medical diagnostic tests and treatment of the disease. Also, a nursing assessment and diagnosis is required to manage it.   The patients with MG have an immune system that produces autoantibodies that focuses on the individual‘s acetylcholine receptors and destroys them (Cutter et al., 2019). This paper mainly aims at describing clear information about Myasthenia Gravis. 

     The pathophysiology of myasthenia gravis means that there are abnormal changes in the body associated with the disease.  As it is defined, the disease is described by a general weakness of muscles. The autoantibodies are fixed alongside the acetylcholine, thus harming the neuromuscular transmission (Sanders et al., 2016). The antibodies to muscle-specific kinase cause the breakdown of the neuromuscular junction, thus disrupting its physiological functioning.  

     There are several signs and symptoms associated with myasthenia gravis but may vary as the disease progresses. Some of the symptoms are confined near the eye muscles, but most patients may experience the symptoms on their face, neck, or other body parts as the disease progresses with one year. In most cases, the symptoms worsen for many years and later stabilize. Ocular Myasthenia gravis is noticed when the muscle eyes are weak, and there are signs of double vision or eyelid drooping (Sanders et al., 2016). The disease can spread from the eye muscles to other body muscles thus causing difficulties in breathing, chewing, and swallowing. There other symptoms such as slurred speech, difficulty in walking and weak neck muscles. The laboratory and diagnostic test for MG is a blood test that identifies the type of antibody that hinders the signals between the nerves and muscles. When the antibodies are high, then myasthenia gravis is present. Neostigmine medications are given to the patient to confirm the diagnosis. 

     Medical treatment and management involve some medications and surgery. Myasthenia Gravis has no cure but certain drugs such as pyridostigmine are used to manage it for the long term. Also, the acetylcholine esterase (AChE) inhibitors are used to treat the disease. During a blood test, thymoma may be diagnosed, thus surgery is required to eliminate thymus. Most patients improve symptoms after the thymus are removed. 

     The nursing assessment and management of myasthenia gravis involve a lot of care since the muscles are weak. The assessment of muscular strength is required and the nurse can assess the facial paralysis, mouth tendency and increased muscle weakness. Also, the common nursing diagnoses are fatigue, impaired swallowing and physical mobility, and high risk of injury. The nursing management involves assisting the patient with injectable drugs such as Edrophonium that improves the muscles and administering the right dose at the right time (Cutter et al., 2019). Also, provide frequent retesting and assisting the patient during Plasmapheresis. 

     There are four nursing diagnoses that are related to myasthenia gravis. First, breathing difficulties caused by weak respiratory muscles. Secondly, weakened physical mobility is linked to the weakening of voluntary muscles. Thirdly, aspiration risk that id connected to weak bulbar muscles (tigner et al., 2018). Fourthly, self-care shortage connected to muscle weakness thus leading to generalized fatigue.

     In conclusion, the Myaesthenia Gravis can be described as a chronic condition that weakens the muscles and several tests are required to diagnoses the diseases. The health care provider can perform several assessments and recommend the right treatment depending on the age of the patient and the severity of the symptoms. Surgery is needed if the myasthenia gravis is caused by a tumor on the thymus but certain medications or therapy may be recommendable depending on the symptoms of the disease (Cutter et al., 2019). If the disease is detected earlier, it is manageable.   

References

Sanders, D. B., Wolfe, G. I., Benatar, M., Evoli, A., Gilhus, N. E., Illa, I., … & Nicolle, M. (2016). International consensus guidance for management of myasthenia gravis: executive summary. Neurology87(4), 419-425.

Tigner, D. C., Rankin, J. A., & Then, K. L. (2018). Self-efficacy theory, quality of life and myasthenia gravis self-management. British Journal of Neuroscience Nursing14(4), 171-178.

Cutter, G., Xin, H., Aban, I., Burns, T. M., Allman, P. H., Farzaneh‐Far, R., … & Kaminski, H. J. (2019). Cross‐sectional analysis of the Myasthenia Gravis Patient Registry: Disability and treatment. Muscle & nerve60(6), 707-715.

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