. 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 A
Explanation
A. Drink plenty of fluids to stay hydrated. Staying hydrated is essential in managing viral pharyngitis to prevent dehydration, soothe the throat, and promote recovery.
B. Take antibiotics as prescribed until the course is complete. Antibiotics are not indicated for viral infections; they are only used for bacterial infections.
C. Avoid all forms of physical activity until fully recovered. While rest is recommended, light activities may be acceptable depending on the patient’s energy levels and symptoms. Total avoidance of all physical activity is unnecessary.
D. Use throat lozenges as needed but avoid resting to prevent throat swelling. Resting is beneficial to recovery. Throat lozenges may soothe irritation, but avoiding rest would be counterproductive.
Correct Answer is A
Explanation
A. Administering mannitol intravenously: Mannitol is an osmotic diuretic that helps reduce ICP by drawing fluid out of brain tissue and decreasing cerebral edema, making it a priority intervention.
B. Encouraging the patient to hyperventilate: Controlled hyperventilation may reduce ICP temporarily by lowering CO₂ levels and causing cerebral vasoconstriction. However, it should only be done cautiously under close monitoring, and other ICP management techniques like mannitol administration take priority.
C. Administering a high-dose corticosteroid: Corticosteroids are generally ineffective for reducing ICP in traumatic brain injury and are typically not recommended in this scenario.
D. Performing a lumbar puncture immediately: Lumbar puncture is contraindicated in cases of increased ICP because it may lead to brain herniation due to the sudden release of pressure.