A nurse is receiving morning report when an alarm notifies the nurse that a client with chronic obstructive pulmonary disease (COPD) has an oxygen saturation of 89%. The nurse immediately assesses the client, and finds the client resting comfortably in bed on 2 liters of supplemental oxygen via nasal cannula. The client denies distress. Which of the following is the most appropriate nursing action?

Myasthenia Gravis

Myasthenia Gravis (MG) is an autoimmune disorder characterized by weakness and rapid fatigue of voluntary muscles. Key features include fluctuating muscle weakness that typically worsens with activity and improves with rest, bilateral ptosis (drooping of the eyelids), and difficulty with swallowing and speaking. The fact that the client's facial muscle strength is better in the morning and worsens throughout the day is a hallmark of MG. The edrophonium (Tensilon) test is specifically used to diagnose MG by temporarily improving muscle strength.

Antibodies at the neuromuscular junction

Myasthenia Gravis is caused by the presence of autoantibodies that target acetylcholine receptors at the neuromuscular junction, leading to impaired communication between nerves and muscles. This is consistent with the described symptoms and the use of the edrophonium (Tensilon) test to diagnose the condition.

A. Loss of peripheral vision is a hallmark sign of primary open-angle glaucoma. In POAG, increased intraocular pressure causes damage to the optic nerve, leading to a gradual loss of peripheral vision. This vision loss is often subtle and progresses slowly, making it difficult for individuals to notice until the condition is advanced.

B. Opacity of the lens is characteristic of cataracts, not glaucoma. Cataracts involve the clouding of the eye's natural lens, which leads to blurred vision and difficulties with seeing clearly, particularly in bright light. While cataracts and glaucoma can occur simultaneously, opacity of the lens is not indicative of POAG.
C. Decrease in color perception can be associated with various eye conditions, including age-related macular degeneration (AMD) and certain types of retinal diseases. While it can occur in glaucoma as the disease progresses, it is not the primary or most characteristic sign of POAG.
D. Pain and purulent discharge are more associated with acute conditions such as conjunctivitis (pink eye) or an eye infection, rather than primary open-angle glaucoma. POAG typically presents without pain or discharge, as it is a chronic condition with a gradual onset of symptoms.