A client with heart failure requests two more pillows to sleep with at night. Which area should the practical nurse (PN) evaluate when responding to the client's request?

Choice A reason: There is no specific requirement to avoid upper body exercise on the day of a mammogram. While vigorous exercise might cause some temporary muscle discomfort, it does not impact the results of the mammogram. The primary concern is ensuring clear imaging of the breast tissue, not the effects of exercise.
Choice B reason: Clients are instructed not to use underarm deodorant on the day of a mammogram because deodorants, antiperspirants, powders, or lotions can contain metallic particles that may appear on the mammogram images as white spots. These spots can be mistaken for calcifications, leading to potential misinterpretation of the results or the need for additional imaging. Ensuring the client avoids using these products helps achieve the clearest possible images for accurate diagnosis.
Choice C reason: Avoiding aspirin for one week prior to a mammogram is not a standard instruction. Aspirin can affect blood clotting, and such instructions are typically given before surgical procedures rather than imaging tests. There is no direct impact of aspirin on the mammogram process or results.
Choice D reason: There is no requirement to avoid eating or drinking for 6 hours before a mammogram. This instruction is more relevant for procedures that involve anesthesia or sedation, where an empty stomach is necessary to reduce the risk of aspiration. Mammograms do not involve these risks, and clients can eat and drink as usual.

Choice A reason: Impaired communication can be a concern for clients with Guillain-Barré syndrome (GBS), especially if they experience facial weakness or difficulty speaking. This can impact their ability to express needs and interact with caregivers, potentially leading to frustration and miscommunication. Although it's important to address communication issues, it is not the highest priority compared to the risk of respiratory compromise due to ascending paralysis, which can be life-threatening.
Choice B reason: Ascending paralysis is the most critical problem to address in clients with GBS. This condition can lead to progressive muscle weakness that starts in the lower extremities and moves upward, potentially affecting the respiratory muscles. Respiratory failure is a life-threatening complication of GBS, and monitoring for signs of ascending paralysis is essential to ensure timely intervention and support, such as mechanical ventilation if needed. Early detection and management of ascending paralysis can significantly impact the client's prognosis and overall outcome.
Choice C reason: Fear and anxiety are common in clients with GBS due to the sudden onset and potential severity of the condition. While addressing emotional well-being is important, it is not the highest priority compared to the risk of respiratory compromise. Providing emotional support and reassurance can help alleviate anxiety and improve the client's overall experience. However, the primary focus should be on monitoring and managing physical symptoms, particularly those that pose an immediate threat to the client's life.
Choice D reason: Immobility can result from muscle weakness and paralysis in clients with GBS. Prolonged immobility can lead to complications such as pressure ulcers, deep vein thrombosis (DVT), and muscle atrophy. While it is important to prevent and manage these complications through interventions like physical therapy and repositioning, the immediate priority is to monitor for ascending paralysis and ensure adequate respiratory function. Once the client's respiratory status is stable, comprehensive care can include addressing immobility-related issues.