A nurse is caring for a patient diagnosed with myasthenia gravis. When caring for this patient, which of the following interventions are appropriate?

Have suction available at all times.
Monitor vital signs and watch for signs of myasthenia crisis: tachycardia, hypertension, and restlessness.
Schedule periods of rest into the day.

Explanation

• The hallmark symptom of MG is fluctuating muscle weakness that worsens with effort or exercise and improves with rest. Medical management of MG depends on the administration of cholinesterase inhibitors such as pyridostigmine and corticosteroids given at specific, spaced times to avoid exacerbations

• Many patients experience weakness of the facial, masticatory, speech, and neck muscles. Often times patients will get tired while chewing food and need to rest or will have difficulty swallowing food due to the weakness. It's always necessary to have suction set up for these patients

• Patients must be monitored for signs of myasthenia crisis, a life-threatening complication in which the breathing muscles become too weak. Signs are an increase in heart rate, blood pressure, respiratory rate, cyanosis, increased secretions, or urinary and bowel incontinence

• Periods of rest are important for these patients as they are at risk for extreme fatigue, so care should not be clustered

• Incorrect: If swallowing or chewing becomes difficult, soft food should be given, but liquid food can increase the risk of aspiration

• Incorrect: Medication should not be given when the patients are awake, but should be given according to a strict schedule

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