Clinical Concepts 

Myasthenia Gravis

Julie A. Koch, DNP, RN, FNP-BC; Marlee R. Steele, DNP, RN, FNP-BC; Logan M. Koch

Abstract

Myasthenia gravis (MG) is a chronic neuromuscular disorder characterized by fluctuating skeletal muscle weakness and fatigue. This rare autoimmune condition can present a diagnostic challenge for the advanced practice nurse (APN). Because of its low incidence in clinical practice and frequently unrecognized symptoms, a delay of 1 to 2 years prior to diagnosis is not uncommon. Recognition of the clinical features is a key component of prompt diagnosis. To avoid delay in treatment, APNs should be aware of variations in MG symptoms and the tools used to confirm a suspected diagnosis. Because patients benefit from the care of neuromuscular specialists, APNs are not expected to be experts within MG treatment. But knowledge of general treatment principles affords the APN an opportunity to collaborate with the neuromuscular specialist to provide care for patients with MG. Using an individual example, this article reviews the experience of an older adult with MG from clinical presentation through treatment. [Journal of Gerontological Nursing, 39(12), 11–15.]

Dr. J. Koch is Assistant Professor, Valparaiso University, Valparaiso, Dr. Steele is Family Nurse Practitioner, Community Healthcare System, Cedar Lake, Indiana; and Mr. L. Koch is PharmD candidate, Drake University, Des Moines, Iowa.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Julie A. Koch, DNP, RN, FNP-BC, Assistant Professor, Valparaiso University College of Nursing, 836 LaPorte Avenue, Valparaiso, IN 46383; e-mail: Julie.Koch@valpo.edu.

Received: August 10, 2013
Accepted: November 04, 2013
Posted Online: December 02, 2013

10.3928/00989134-20131108-01

Myasthenia gravis (MG) is a chronic neuromuscular disorder characterized by fluctuating skeletal muscle weakness and fatigue. This rare autoimmune condition can present a diagnostic challenge for the advanced practice nurse (APN). Because of its low incidence in clinical practice and frequently unrecognized symptoms, a delay of 1 to 2 years prior to diagnosis is not uncommon. Recognition of the clinical features is a key component of prompt diagnosis. To avoid delay in treatment, APNs should be aware of variations in MG symptoms and the tools used to confirm a suspected diagnosis. Because patients benefit from the care of neuromuscular specialists, APNs are not expected to be experts within MG treatment. But knowledge of general treatment principles affords the APN an opportunity to collaborate with the neuromuscular specialist to provide care for patients with MG. Using an individual example, this article reviews the experience of an older adult with MG from clinical presentation through treatment. [Journal of Gerontological Nursing, 39(12), 11–15.]

Dr. J. Koch is Assistant Professor, Valparaiso University, Valparaiso, Dr. Steele is Family Nurse Practitioner, Community Healthcare System, Cedar Lake, Indiana; and Mr. L. Koch is PharmD candidate, Drake University, Des Moines, Iowa.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Julie A. Koch, DNP, RN, FNP-BC, Assistant Professor, Valparaiso University College of Nursing, 836 LaPorte Avenue, Valparaiso, IN 46383; e-mail: Julie.Koch@valpo.edu.

Received: August 10, 2013
Accepted: November 04, 2013
Posted Online: December 02, 2013
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