Author Question: After returning from a plasmapheresis treatment, the nurse suspects that a patient with myasthenia ... (Read 72 times)

daltonest1984 · **on:** Jun 25, 2018

After returning from a plasmapheresis treatment, the nurse suspects that a patient with myasthenia gravis is demonstrating signs of electrolyte imbalances. What did the patient demonstrate to confirm the nurse's suspicion?

Select all that apply.

1. sluggish bowel sounds
2. heart rate 92 and irregular
3. onset of circumoral tingling
4. blood pressure 148/90 mmHg
5. bilateral calf cramping

Question 2

During an assessment the nurse becomes concerned that a patient is demonstrating early manifestations of amyotrophic lateral sclerosis. What findings did the nurse use to make this clinical determination?

Select all that apply.

1. foot drop
2. slurred speech
3. weak hip flexor muscles
4. bilateral weak hand grasps
5. fine muscle fasciculations of the hands

honnalora · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 2, 3, 5
Observe for circumoral tingling if calcium levels are low and cardiac dysrhythmias and leg cramps if potassium levels are low. Hypocalcemia occurs because the anticoagulant citrate dextrose binds with calcium. Sluggish bowel sounds and elevated blood pressure are not manifestations of electrolyte imbalances.

Answer to Question 2

Correct Answer: 2, 4, 5
Muscle twitches or weakness in an extremity and slurred speech are common early manifestations. Fasciculations of involved muscles are common in the early stage of the disorder. With the loss of muscle innervation, the muscles atrophy, and paralysis results. Muscle mass decreases, and patients complain of progressive fatigue. Typically, the disease first affects the hands. Foot drop and weak hip flexor muscles may or may not be a manifestation of amyotrophic lateral sclerosis.