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Myasthenia Gravis By: Cheryl Hamilton
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Myasthenia gravis Autoimmune disease Pathophysiology: Treatment:
Antibodies directed towards acetylcholine receptor sites impair impulse transmission across myoneural junction Leads to weakness in voluntary muscles Treatment: IV Immunoglobulin (IVIG) and immunosuppressive therapy
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Evidence for care Fatigue in Myasthenia Gravis Patients
Purpose: to identify the relationship between fatigue and demographic/clinical variables
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Nursing theory Dorthea Orem’s Self-Care Theory
Self- care deficit occurs when the patient cannot carry out self-care due to fatigue The nurse then meets the self-care by teaching, supporting or providing the environment to promote patient’s ability
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Evaluation of evidence
Methods Results Activity restriction was the best indicator for fatigue severity 67 participants Four questionnaires Test/retest
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Critique of Research study
Credibility Limitations Peer-reviewed Journal Approved by Institutional Review Board Sufficient sample size BMI r/t activity restriction Only 49/67 participated in retest Only returning pts of University of Alabama at Birmingham Medical Center used
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Patient care design
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Patient care design
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Patient care design Nursing Diagnosis: Nursing Collaboration:
Fatigue r/t aching muscles Impaired physical mobility r/t defective transmission of nerve impulses Activity Intolerance r/t fatigue Nursing Collaboration: Physical Therapy Respiratory Therapists Doctors
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Advocate role Advocating for: Patient understanding and knowledge
Identifying factors that cause exacerbation of symptoms
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Advocate role Nursing Significance:
Further investigation of fatigue in patients with MG Identify coping methods Support effort to educate patients
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References Kittiwatanapasan, W., Gauthier, D., Williams, A., & Oh, S. (2003). Fatigue in myasthenia gravis patients . Journal of Neuroscience Nursing, 35(2), Retrieved from &v=2.1&u=lom_ferrissu&it=r&p=ITOF&sw=w&asi d=507e609cad44a788280f8786a50ea128 Ladwig, G. & Ackley, B. (2011). Mosby’s guide to nursing diagnosis (3rd ed.). Maryland Heights, MO: Mosby Elsevier. Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing. (7 ed., p ). Philadelphia, PA: Lippincott Williams & Wilkins.
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