J.B.'s wife asks you what information they will need before he goes home. Outline the points
you need to teach J.B. and his wife.
What will be an ideal response?
• J.B. should wear a medical alert bracelet and carry a card stating his name and the name and
telephone number of his physician.
• Relate the difference between cholinergic and myasthenic crisis and the signs and symptoms of
each.
• Have an Ambu bag and portable suction device available at home because he is prone to crisis.
Both J.B. and his wife should understand how to use it.
• Relate factors that cause a relapse of symptoms, including infections, extreme temperatures,
extensive exposure to sunlight (or ultraviolet light), and emotional stress.
• Schedule adequate rest periods during the day, pace himself, and set priorities and plan ahead to
avoid undue fatigue.
• Wear sensible shoes to minimize weakness and loss of balance.
Medications
• Dose, purpose, and potential side effects of medications.
• Take medication with a small amount of milk, bread, or crackers to reduce the risk of nausea and
gastric irritation. Avoid taking medications with coffee or fruit juice.
• Do not take over-the-counter (OTC) medications without the doctor's consent.
Nutrition
• Eat a high-protein, high-carbohydrate diet; take small frequent meals to avoid fatigue.
• Take medications long enough before eating a full meal to maximize strength of muscles for
chewing and swallowing.
• Eat slowly and select a soft diet if he has difficulty swallowing.
• Do not drink alcohol.
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