The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes.

After administration, the client will experience worsening facial weakness and ptosis.

After administration of the medication, there will be no change in the status of the ptosis or facial weakness.

The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Answer and Explanation

The Correct Answer is A

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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Correct Answer is ["A","E"]

Explanation

A. Proper hand hygiene is critical to prevent introducing infections into the eye, especially after eye surgery. The client should always wash their hands before touching their eyes or administering any eye drops to maintain sterility and reduce the risk of infection.
B. After extracapsular cataract extraction, the cataract itself does not grow back on the implanted lens. However, a condition called posterior capsule opacification (PCO) can occur, where the membrane behind the lens becomes cloudy. This can be treated with a simple outpatient procedure called YAG laser capsulotomy.
C. Bending at the waist can increase intraocular pressure and put strain on the eye, which can hinder healing or increase the risk of complications. The client should be advised to avoid bending over and instead use alternative methods, such as bending their knees or getting assistance to reach items on the ground.
D. In modern cataract surgery, many procedures are performed without sutures or with self-sealing techniques that do not require suture removal. The specific follow-up care, including whether sutures need to be removed, should be confirmed with the surgeon.
E. Wearing an eye shield at night helps protect the eye from accidental rubbing or injury while sleeping, which is crucial for proper healing. The client should follow the physician's instructions regarding the duration of shield use, but wearing it until cleared by the physician is generally recommended to ensure the eye remains protected during the initial healing period.

A. Raw vegetables with dip B. Granola bars C. Macaroni and cheese D. Dried fruit

Correct Answer is C

Explanation

A. Raw vegetables can be challenging for individuals with myasthenia gravis because they require significant chewing and can lead to fatigue of the jaw muscles. Additionally, raw vegetables can be difficult to swallow if there is significant weakness.
B. Granola bars can be hard and require extensive chewing. For a person with myasthenia gravis, the effort needed to chew and swallow these bars can lead to increased fatigue and difficulty managing meals.
C. Macaroni and cheese is a softer food that requires less chewing compared to raw vegetables or granola bars. It can be easier for individuals with myasthenia gravis to manage because it is soft and less likely to cause fatigue. Additionally, it can be enriched with nutrients and is easier to swallow, making it a more appropriate choice for a nutritional plan for someone with MG.
D. Dried fruit is typically tough and chewy, which can be difficult for someone with myasthenia gravis to handle. The chewing effort required can lead to muscle fatigue and discomfort.

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The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Nursing Test Bank

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