1. Myasthenia Gravis
By: Cheryl Hamilton

2. 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

3. Evidence for care Fatigue in Myasthenia Gravis Patients
Purpose: to identify the relationship between fatigue and demographic/clinical variables

4. 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

5. Evaluation of evidence
Methods
Results
Activity restriction was the best indicator for fatigue severity
67 participants
Four questionnaires
Test/retest

6. 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

7. Patient care design

8. Patient care design

9. 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

10. Advocate role Advocating for: Patient understanding and knowledge
Identifying factors that cause exacerbation of symptoms

11. Advocate role Nursing Significance:
Further investigation of fatigue in patients with MG
Identify coping methods
Support effort to educate patients

12. 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.