[Verified Answer]: Case Study: Neuromuscular Junction…

Case Study: Neuromuscular Junction Disorders The following six questions are part of an unfolding case study. Review the electronic health record below and answer the question that follows. Progress Notes Date/Time Provider Progress Notes 12/19/20XX 1630 Maverick Carretero (pronouns he/him/his), a 48-year-old high school teacher, presents with complaints of muscle weakness that gets worse towards the evening and improves after periods of rest. Maverick has also been having intermittent blurred vision, a noticeable droop of the right eyelid, and occasional difficulty swallowing. His health history is unremarkable. Vital signs: blood pressure 130/85 mmHg, heart rate is regular at 78 beats per minute, respiratory rate is 16 breaths per minute, temperature is 98.6 °F (37 °C), and oxygen saturation is 98% on room air. Appears alert and oriented but visibly fatigued. Ptosis noted on the right eyelid, and muscle strength testing reveals a 4/5 strength in the upper extremities and slightly better at 4+/5 in the lower extremities, with an observed improvement following a short rest period. Heart sounds are regular with no murmurs, rubs, or extra sounds, and the lungs are clear to auscultation. Abdomen non-tender with normal bowel sounds. No dysphagia observed during a water swallowing test, but Maverick reports occasional difficulty swallowing. Question 5 / 6 Note: You will not have another attempt on this question if you navigate away. Please take your time answering this question before moving forward. Take Action Based on a positive acetylcholine receptor antibody test and findings from electromyography (EMG), Maverick is diagnosed with myasthenia gravis. Which of the following management strategies should be considered in developing the initial plan of care? Select all that apply. Begin physical therapy focused on strengthening exercises Recommend scheduled rest periods throughout the day Consider intravenous immunoglobulin (IVIG) treatment Refer to a surgeon for a thymectomy if thymoma is detected on computed tomography (CT) Advise on avoidance of triggers known to exacerbate symptoms Prescribe acetylcholinesterase inhibitors Start scheduled pain medication