What assessment findings would the nurse expect to find in a client diagnosed with myasthenia gravis? Select all that apply.

Myasthenia gravis is an autoimmune neuromuscular disorder caused by antibodies that block or destroy acetylcholine receptors at the neuromuscular junction. This leads to impaired transmission of nerve impulses to skeletal muscles, resulting in fluctuating and progressive muscle weakness that worsens with activity and improves with rest. It commonly affects ocular, bulbar, and respiratory muscles. Clinical assessment focuses on identifying fatigable muscle weakness affecting facial expression, speech, and swallowing. A. Mask-like appearance is typically associated with Parkinson’s disease due to reduced facial muscle movement and bradykinesia. In myasthenia gravis, facial weakness may occur, but it fluctuates and is characterized more by fatigue than a fixed expressionless face. Therefore, a classic mask-like facies is not a primary feature of this condition. B. Cushing’s triad is associated with increased intracranial pressure and includes hypertension, bradycardia, and irregular respirations. It is unrelated to neuromuscular transmission disorders such as Myasthenia gravis. This finding reflects severe brain injury rather than peripheral neuromuscular weakness. C. Increased salivation is not a characteristic finding of myasthenia gravis. In fact, patients may experience difficulty managing oral secretions due to bulbar muscle weakness, but true hypersecretion is not typical. The primary issue is impaired muscle control rather than increased glandular activity. D. Ptosis is a hallmark feature of Myasthenia gravis and occurs due to weakness of the levator palpebrae superioris muscle. It often worsens with prolonged eye use and improves with rest. This fluctuating eyelid drooping is one of the most common early signs of the disease. E. Slurred speech (dysarthria) occurs due to weakness of the facial, tongue, and pharyngeal muscles involved in articulation. In myasthenia gravis, speech often becomes progressively worse with continued talking and improves after rest. This fatigability is a key diagnostic feature of the disorder. F. Difficulty swallowing (dysphagia) results from weakness of the bulbar muscles responsible for coordinating swallowing. In Myasthenia gravis, this can lead to choking, aspiration risk, and poor nutritional intake. Symptoms often worsen with repeated swallowing efforts and may fluctuate throughout the day.