Mary Collins, a 35-year-old woman, is admitted to the emergency department with shortness of breath, difficulty...

Mary Collins, a 35-year-old woman, is admitted to the emergency department with shortness of breath, difficulty swallowing, and a drooping eyelid on the left side. The physician on duty suspects that she is suffering from myasthenia gravis and orders atropine 0.6 mg in the intravenous (IV) form followed by neostigmine 1.5 mg IV.

Following the administration of neostigmine, Ms. Collins is able to swallow and breathe more effectively.

Why has Mrs. Collins’ breathing improved, and why is she now able to swallow?

Solutions

Expert Solution

MYASTHENIA GRAVIS - it is an autoimmune disorder characterized by skeletal muscle weakness. Weakness in this disease worsens after period of activity.

✓ symptoms -

• skeletal muscle weakness

•drooping of eyelids

• difficulty in swallowing

• shortness of breath

• impaired speech

ROLE OF NEOSTIGMINE IN MYASTHENIA GRAVIS-

✓ ACETYLCHOLINE is a neurotransmitter released at motor nerve endings.

✓ ACETYLCHOLINESTERASE is an enzyme ,present at synaptic cleft , which metabolize acetylcholine into choline and acetic acid.

✓ NEOSTIGMINE IS AN ACETYLCHOLINESTERASE INHIBITOR.

✓ mechanism of action -

Neostigmine blocks acetylcholinesterase at synaptic cleft -->acetylcholinesterase can no longer metabolize acetylcholine --> acetylcholine concentration increase at neuromuscular junction --> increased neuromuscular transmission --> improved muscle strength.

IT IS VERY CRUCIAL TO MONITOR THE DOSAGE OF NEOSTIGMINE BECAUSE OVERDOSE MAY CAUSE BRONCHOCONSTRICTION.

Nightingale answered 1 year ago

Next > < Previous

Related Solutions

A client is admitted to the emergency department with shortness of breath, excessive sweating, and nausea....

A client is admitted to the emergency department with shortness of breath, excessive sweating, and nausea. The client states, "It feels like my chest is ripping open!". The nurse prepares for emergency treatment for which of the following conditions? Group of answer choices A. Acute arterial occlusion B. Aortic aneurysm C. Venous thrombosis D.Aortic dissection

Sarah is a 69-year old female that presented to the emergency department with shortness of breath....

Sarah is a 69-year old female that presented to the emergency department with shortness of breath. Her past medical history includes heart failure and COPD. Her pulse oximetry on room air is 82%. You notify the provider, and he orders oxygen at 4 L via nasal canula NC. Sarah’s chest x-ray reveals bilateral pneumonia. Her arterial blood gas result are below: pH 7.30 PaCO2 58 mm Hg PaO2 78 mm Hg HCO3 26 mEq/L Sarah is admitted to a general...

D.G. is a 74-year-old woman who arrives at the emergency room complaining of shortness of breath,...

D.G. is a 74-year-old woman who arrives at the emergency room complaining of shortness of breath, palpitations (for 2 days), and lower extremity edema. Her medical history includes diabetes mellitus, hypertension, heart failure with reduced ejection fraction, and osteoarthritis. She had a left heart catheterization and coronary angiography last year and has no significant coronary artery disease. She has a biventricular pacemaker/implantable defibrillator for heart failure symptom treatment and sudden cardiac death prevention. The patient’s current medications are losartan 100...

A 66-year-old male with a history of COPD is admitted to the emergency department with shortness...

A 66-year-old male with a history of COPD is admitted to the emergency department with shortness of breath. He is not currently taking any medication for his breathing. The patient states that he usually gets short of breath only upon exertion, but he developed a “cold” several days ago that made his breathing worse. He has been placed on oxygen. The doctor wants him to have breathing treatments. What medication, dose, and route of administration would you suggest? (a) How...

Case-2: A 56 year-old male was presented to the Emergency Department with fever, shortness of breath,...

Case-2: A 56 year-old male was presented to the Emergency Department with fever, shortness of breath, and cough. His symptoms began approximately 2 days ago and are continuous, steadily getting worse. History: He is a known HIV patient under antiviral treatment. Physical exam: Temperature: 38.5C Blood Pressure: 120/76 Blood culture: No bacteria growth Sputum culture: Normal flora of upper respiratory tract is grown Rapid flu PCR: Negative India ink stain of broncho-alveolar lavage fluid: capsulated oval shaped organism What is...

S.R. is a 65- year-old woman who presents to the emergency department complaining of shortness of...

S.R. is a 65- year-old woman who presents to the emergency department complaining of shortness of breath, productive cough, and swelling in both legs. The patient has a past medical history of congestive heart failure (CHF), hypertension, and diabetes. Vital signs are T 97.5, P 85, R 16, and BP 160/90. Physical exam reveals +2 edema bilateral lower extremities, heart rate and rhythm regular, and lungs with rhonchi in the bases. The patient is started on a nebulizer treatment, and...

The patient is a 60-year-old white female presenting to the emergency department with acute onset shortness of breath.

The patient is a 60-year-old white female presenting to the emergency department with acute onset shortness of breath. She is able to speak in short sentences only. Symptoms began approximately 2 days before and have progressively worsened. Patient has a history of hypertension and COPD. She weighs 220lbs. Vital signs as follows T98.6, HR 122, RR 28, BP 168/90Initial exam, patient unable to breathe comfortably in a supine position. Sitting upright in bed. Cap refill 8sec-Lower extremities 4+pedal edema JVD...

A 75-year-old man, Patrick R., presented to the emergency department with fever, shortness of breath, chest...

A 75-year-old man, Patrick R., presented to the emergency department with fever, shortness of breath, chest pain, and severe, extremely productive cough. Patrick had been a heavy smoker for almost 50 years before he quit 7 years ago, when he was diagnosed with emphysema. Patrick occasionally used oxygen at home when he had difficulty breathing, and on presentation he was using portable oxygen because of his severe respiratory distress. A chest X-ray revealed a right lower lobe infiltrate, and Patrick...

Elsie Elliason, a 70-year-old woman, was admitted to the emergency department of the hospital with severe...

Elsie Elliason, a 70-year-old woman, was admitted to the emergency department of the hospital with severe vomiting and diarrhea. She has been experiencing these symptoms for the past several days. The physician suspects that she is experiencing hypokalemia. What electrolyte test would the physician order to confirm hypokalemia and what might the result be? Why is this particular electrolyte important to normal body function? What effect did Ms. Elliason's physical symptoms have on the electrolyte?

Chief Complaint: 74-year-old woman with shortness of breath and swelling. History: Martha Wilmington, a 74-year-old woman...

Chief Complaint: 74-year-old woman with shortness of breath and swelling. History: Martha Wilmington, a 74-year-old woman with a history of rheumatic fever while in her twenties, presented to her physician with complaints of increasing shortness of breath ("dyspnea") upon exertion. She also noted that the typical swelling she's had in her ankles for years has started to get worse over the past two months, making it especially difficult to get her shoes on toward the end of the day. In...

Subjects