A client who is experiencing diplopia, ptosis, and mild dysphagia is newly diagnosed with myasthenia gravis. Which instruction would the nurse include when planning care with the client and spouse?

A client who is experiencing diplopia, ptosis, and mild dysphagia is newly diagnosed with myasthenia gravis. Which instruction would the nurse include when planning care with the client and spouse?

• A. Restrict the diet to liquids and foods that are pureed.
• B. Perform range-of-motion exercises.
• C. Remember to use a stool softener daily.
• D. Take prescribed anticholinergic medications on schedule.

Answer: (D)

In myasthenia gravis, the goal is to keep neuromuscular transmission as strong as possible by timing medications that boost acetylcholine at the NMJ. The most important instruction for planning with the client and spouse is to take prescribed acetylcholinesterase inhibitors on a strict schedule, especially around meals, to improve strength and swallowability. These medications increase the amount of acetylcholine available at the junction, helping with the weakness that underlies diplopia, ptosis, and dysphagia. Anticholinergic drugs would counteract this effect by blocking acetylcholine actions, which would worsen weakness rather than improve it. So the emphasis is on consistent, timely use of the cholinergic therapy to maintain function throughout the day. Diet or exercise tips may be adjusted based on tolerance, but the core management focuses on medication timing and safety with swallowing. In planning, the spouse can help establish a routine, ensure the medication is taken as prescribed, monitor for signs of under- or over-medication, and coordinate meals when the medication’s effect is strongest to support safer swallowing.

In myasthenia gravis, the goal is to keep neuromuscular transmission as strong as possible by timing medications that boost acetylcholine at the NMJ. The most important instruction for planning with the client and spouse is to take prescribed acetylcholinesterase inhibitors on a strict schedule, especially around meals, to improve strength and swallowability. These medications increase the amount of acetylcholine available at the junction, helping with the weakness that underlies diplopia, ptosis, and dysphagia.

Anticholinergic drugs would counteract this effect by blocking acetylcholine actions, which would worsen weakness rather than improve it. So the emphasis is on consistent, timely use of the cholinergic therapy to maintain function throughout the day. Diet or exercise tips may be adjusted based on tolerance, but the core management focuses on medication timing and safety with swallowing.

In planning, the spouse can help establish a routine, ensure the medication is taken as prescribed, monitor for signs of under- or over-medication, and coordinate meals when the medication’s effect is strongest to support safer swallowing.