Myasthenia Gravis: Symptoms (Nursing)

00:01 So even though myasthenia gravis can affect any skeletal muscle, it's the eye that we really often see, with eyes and eyelid movement, facial expression, next swallowing.

00:13 Those are the three that you're going to most see affected.

00:17 So, eyes, facial expressions, and swallowing.

00:23 Why this matters to you as a nurse is because if a patient needs assistance with feeding or sitting down with them during a meal when they're in the hospital is a really good time to assess the patient.

00:35 Now you don't want to walk into the patient's room and say, "Hello, Mr. Jones, I know the patient with myasthenia gravis, sometimes have a difficulty swallowing.

00:42 So what I'm going to do now is I'm going to sit here and watch you eat." Yeah. Not what you want to do.

00:47 You want to go in casually.

00:50 This is probably not the best patient for a nurse tech to go in during a mealtime.

00:55 It's good for the nurse to be in there.

00:57 Don't announce what you're doing.

00:59 Just go in, sit down, and kind of watch what they're doing casually.

01:05 Not with intense still like you Graves' disease eyes.

01:09 Because this will give you an idea of how they're feeling if you notice they have difficulty swallowing, if they have to take multiple drinks when they're swallowing their food, it'll kind of let you know where they are.

01:19 Because, remember, stress can set off or exacerbate myasthenia gravis.

01:26 Difficulty swallowing might be the first clue or sign to us that that patient could be going into respiratory problems.

01:34 So that's why as a nurse, it's a great time to come and observe that and watch your patient.

01:39 Because as professionals, we're always on guard, right? We know with every diagnosis, we're watching for the worst-case scenario.

01:48 We're looking for the signs that we know to look for, and then we know what to do to intervene to keep our patients safe.

01:55 Hey, the onset of the disorder might be sudden and the symptoms might just like wake up one day and they have them, but they don't often or always get recognized as myasthenia gravis So be aware because once you're in nursing school, suddenly you're the expert in all your family and friends.

02:13 They think just because you're in nursing school, you know everything.

02:16 So you get those phone calls.

02:18 But when people call you or you notice in someone, you notice something a little different about their eye, or about their facial expressions, this is one of the things that you would think through that it could possibly be.

02:31 So, the symptoms are unusually in the localized form.

02:34 Usually, it's eliminated to the eye muscles and we call that ocular myasthenia.

02:39 Remember, that's muscle weakness, "myasthenia." Or it could be severe generalized, it might affect multiple muscles including those that control breathing and that's our biggest concern.

02:51 So the degree of muscle weakness involves myasthenia gravis can vary from minor to localized, to all the way to a severe and more generalized type of event.

03:01 So you watch for the eyelids to be drooping.

03:04 You watch for changes in their vision that they might talk to you about.

03:07 Their facial expression is different.

03:09 They have hard time swallowing.

03:10 They might start to become short of breath.

03:13 Now that is cause for concern.

03:15 If we have a patient with myasthenia gravis and they're experiencing unusual shortness of breath, I mean they haven't just done 30 minutes on the StairMaster, they're noticing shortness of breath with usual activities.

03:26 That is a real red alert.

03:28 If they're having difficulty speaking, that's dysarthria.

03:33 Now we always love to help you learn medical terminology.

03:36 Remember, D-Y-S means difficulty, and then whatever comes after that word, that's what you're having difficulty with.

03:44 So dysarthria is difficulty in speech.

03:48 Dysphagia, P-H-A-G-I-A, is difficulty swallowing.

03:54 So you can take D-Y-S and anything that comes after, you know the patient is having difficulty with whatever word comes next.

04:02 And we talked about weakness can spread to the other muscles.