Visual disturbances, including diplopia
Ascending paralysis and loss of motor function
Cogwheel rigidity and loss of coordination
Progressive weakness that is worse at the day’s end
Atropine (atropine sulfate)
Brief exaggeration of symptoms
Prolonged symptomatic improvement
Rapid but brief symptomatic improvement
Symptomatic improvement of just the ptosis
Develop a teaching plan
Facilitate psychologic adjustment
Maintain the present muscle strength
Prepare for the appearance of myasthenic crisis
Ability to chew and speak distinctly
Degree of anxiety about her diagnosis
Ability to smile an to close her eyelids
Respiratory exchange and ability to swallow
Administer the medication exactly on time
Administer the medication with food or mild
Evaluate the client’s muscle strength hourly after medication
Evaluate the client’s emotional side effects between doses
Change her diet order from soft foods to clear liquids
Place an emergency tracheostomy set in her room
Assess her respiratory status before and after meals
Coordinate her meal schedule with the peak effect of her medication, Mestinon
Spinal cord injury
The client may be less sensitive to the effects of a neuromuscular blocking agent.
Succinylcholine shouldn’t be used; pancuronium may be used in a lower dosage.
Pancuronium shouldn’t be used; succinylcholine may be used in a lower dosage.
Pancuronium and succinylcholine both require cautious administration.
Getting too little exercise
Taking excess medication
Omitting doses of medication
Increasing intake of fatty foods
Eating large, well-balanced meals
Doing muscle-strengthening exercises
Doing all chores early in the day while less fatigued
Taking medications on time to maintain therapeutic blood levels
A genetic in the production acetylcholine
A reduced amount of neurotransmitter acetylcholine
A decreased number of functioning acetylcholine receptor sites
An inhibition of the enzyme ACHE leaving the end plates folded
Insulin-dependent diabetes mellitus
Administer an acetaminophen suppository.
Notify the physician immediately.
Recheck vital signs in 1 hour.
Reschedule patient’s physical therapy.
Promotes the removal of antibodies that impair the transmission of impulses
Stimulates the production of acetylcholine at the neuromuscular junction.
Decreases the production of autoantibodies that attack the acetylcholine receptors.
Inhibits the breakdown of acetylcholine at the neuromuscular junction.
Stimulating the cerebral cortex
Blocking the action of cholinesterase
Replacing deficient neurotransmitters
Accelerating transmission along neural swaths
A positive sweat chloride test
A positive edrophonium (Tensilon) test