When teaching an adolescent about measures to improve facial acne, the nurse should give the patient what instructions about skin care?

Choice A rationale

A diet high in protein is generally beneficial for individuals with myasthenia gravis, as protein is essential for muscle health and overall strength. It does not trigger a myasthenic crisis, which is typically precipitated by factors that exacerbate neuromuscular junction dysfunction, not dietary protein intake.

Choice B rationale

Taking too much medication, specifically cholinergic medications used to treat myasthenia gravis, can lead to a cholinergic crisis, not a myasthenic crisis. A cholinergic crisis is characterized by excessive acetylcholine, leading to symptoms like muscle fasciculations, salivation, lacrimation, and bradycardia, distinguishing it from theasthenic crisis's muscle weakness.

Choice C rationale

Orthostatic hypotension is a drop in blood pressure upon standing and can be a symptom associated with myasthenia gravis or its treatments (e.g., anticholinesterase inhibitors), but it is not a direct trigger for a myasthenic crisis. A crisis involves severe muscle weakness, particularly affecting respiratory muscles, not primarily blood pressure regulation.

Choice D rationale

Respiratory infection is a very common and significant trigger for a myasthenic crisis. Infections, particularly respiratory ones, increase metabolic demand, cause systemic inflammation, and can exacerbate the autoimmune attack on acetylcholine receptors at the neuromuscular junction, leading to profound muscle weakness, including life-threatening respiratory muscle paralysis.

Choice A rationale

Older adults' skin turgor is typically not moist and boggy. Instead, it often presents with decreased elasticity and may appear lax due to age-related changes in collagen and elastin fibers. Boggy skin turgor can indicate significant fluid retention or edema, which is not a normal physiological finding associated with aging alone.

Choice B rationale

Skin turgor is significantly affected by aging. The dermis thins, and there is a reduction in collagen and elastin, leading to a loss of skin elasticity. This physiological process results in decreased turgor, making the skin appear less resilient and more prone to tenting, reflecting normal age-related changes.

Choice C rationale

A decrease in elasticity on skin turgor is a normal part of aging. As individuals age, there is a natural reduction in the quantity and quality of elastin and collagen fibers within the dermal layer of the skin. This leads to diminished recoil capacity, manifesting as prolonged tenting when the skin is pinched, which is a expected finding.

Choice D rationale

Assessing skin turgor only on the hands of older adults is not the most reliable approach. Due to age-related loss of subcutaneous fat and decreased elasticity, the hands can often show false positives for dehydration. The sternum or forehead provides a more accurate assessment site for evaluating hydration status in the elderly population because these areas are less affected by typical age-related changes in skin elasticity.