. A patient with myasthenia gravis is admitted to the hospital with signs of a myasthenic crisis. Which of the following symptoms should the nurses expect to observe?
Increased pulse, respirations and blood pressure with dysphagia and respiratory distress
Hypotension, diarrhea and increased salivation
Bradycardia and hypothermia
Tachypnea and hyperactive deep tendon reflexes
The Correct Answer is A
A. Increased pulse, respirations and blood pressure with dysphagia and respiratory distress. A myasthenic crisis is characterized by severe muscle weakness that can lead to respiratory failure, dysphagia, and increased vital signs due to the stress of respiratory distress.
B. Hypotension, diarrhea, and increased salivation. These symptoms are more indicative of a cholinergic crisis, which is due to excess acetylcholine.
C. Bradycardia and hypothermia. Bradycardia and hypothermia are not characteristic signs of a myasthenic crisis.
D. Tachypnea and hyperactive deep tendon reflexes. While tachypnea can occur in respiratory distress, hyperactive reflexes are not typical in myasthenic crisis, as it involves neuromuscular weakness.
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Correct Answer is D
Explanation
A. Pain in the neck when the patient flexes their head towards the chest. This describes nuchal rigidity, not Kernig sign.
B. Involuntary flexion of the hips and knees when the neck is flexed. This describes Brudzinski sign, not Kernig sign.
C. Photophobia and headache triggered by bright light. These are symptoms of meningitis, but they are not specific to Kernig sign.
D. Pain and resistance when attempting to extend the patient's leg from a flexed position. A positive Kernig sign is when there is pain and resistance to leg extension from a flexed hip and knee position, indicating meningeal irritation.
Correct Answer is A
Explanation
A. Serum sodium levels: Desmopressin can lead to water retention and potentially hyponatremia. Monitoring serum sodium is crucial to prevent electrolyte imbalance.
B. Serum magnesium levels: Magnesium is not typically impacted by desmopressin treatment in central diabetes insipidus.
C. Serum potassium levels: Desmopressin does not generally affect potassium levels in patients with diabetes insipidus.
D. Serum calcium levels: Calcium levels are not directly influenced by desmopressin or diabetes insipidus.