So even though myasthenia gravis
can affect any skeletal muscle,
it's the eye that we really often see,
with eyes and eyelid movement,
Those are the three
that you're going to most see affected.
So, eyes, facial expressions,
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.
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.
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.
You want to go in casually.
This is probably not the best patient
for a nurse tech to go in
during a mealtime.
It's good for the nurse to be in there.
Don't announce what you're doing.
Just go in, sit down,
and kind of watch
what they're doing casually.
Not with intense still
like you Graves' disease eyes.
Because this will give you an idea
of how they're feeling
if you notice they have
if they have to take multiple drinks
when they're swallowing their food,
it'll kind of let you know
where they are.
stress can set off
or exacerbate myasthenia gravis.
Difficulty swallowing might be
the first clue or sign to us
that that patient could be going
into respiratory problems.
So that's why as a nurse,
it's a great time to come and observe that
and watch your patient.
Because as professionals,
we're always on guard, right?
We know with every diagnosis,
we're watching for the worst-case scenario.
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.
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.
They think just because
you're in nursing school,
you know everything.
So you get those phone calls.
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.
So, the symptoms
are unusually in the localized form.
Usually, it's eliminated to the eye muscles
and we call that ocular myasthenia.
Remember, that's muscle weakness,
Or it could be severe generalized,
it might affect multiple muscles
including those that control breathing
and that's our biggest concern.
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.
So you watch for the eyelids
to be drooping.
You watch for changes in their vision
that they might talk to you about.
Their facial expression is different.
They have hard time swallowing.
They might start
to become short of breath.
Now that is cause for concern.
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.
That is a real red alert.
If they're having difficulty speaking,
Now we always love to help you
learn medical terminology.
Remember, D-Y-S means difficulty,
and then whatever comes
after that word,
that's what you're having difficulty with.
So dysarthria is difficulty in speech.
is difficulty swallowing.
So you can take D-Y-S
and anything that comes after,
you know the patient
is having difficulty
with whatever word comes next.
And we talked about weakness
can spread to the other muscles.