A nurse is caring for a client who has myasthenia gravis. Which of the following actions should the nurse take?

Choice A reason: Confusion and weakness are signs of dehydration and electrolyte imbalance, which can result from vomiting and diarrhea. These are serious complications that can affect the client's mental status, blood pressure, heart rate, and kidney function. The nurse should report these findings to the provider and monitor the client's vital signs and fluid status.

Choice B reason: Dry oral mucosa and furrowed tongue are also signs of dehydration, but they are less severe than confusion and weakness. The nurse should report these findings to the provider as well, but they are not the most urgent ones.

Choice C reason: A temperature of 37.4° C (99.3° F) is slightly elevated, but not indicative of a fever or infection. The nurse should document this finding, but it does not require immediate follow-up.

Choice D reason: A blood pressure of 90/58 mm Hg is low, but not hypotensive. The nurse should document this finding, but it does not require immediate follow-up.

Choice A reason: "Limit the number of fast-food meals to five each week." is not a good information to include, as it implies that fast-food meals are acceptable as long as they are not too frequent. The nurse should discourage the students from consuming fast-food meals, as they are high in fat, salt, sugar, and calories, and low in nutrients, fiber, and antioxidants. The nurse should advise the students to choose healthier options, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.

Choice B reason: "You should drink a glass of milk with breakfast." is a good information to include, as it promotes the intake of calcium, which is essential for bone health and growth. Adolescents need about 1,300 mg of calcium per day, which can be obtained from milk and other dairy products, such as cheese and yogurt. The nurse should encourage the students to drink milk with breakfast, as it can also provide protein, vitamin D, and other nutrients.

Choice C reason: "Most of your dietary intake should come from protein." is not a good information to include, as it suggests that protein is more important than other macronutrients, such as carbohydrates and fats. The nurse should explain to the students that protein is necessary for tissue repair, muscle development, and immune function, but it should not exceed 10 to 30 percent of the total caloric intake. The nurse should recommend the students to consume a balanced diet that includes carbohydrates, fats, and protein, as well as vitamins, minerals, and water.

Choice D reason: "Your total intake for the day should not exceed 1,000 calories." is not a good information to include, as it indicates that calorie restriction is the key to a healthy diet. The nurse should inform the students that calorie needs vary depending on age, gender, activity level, and growth rate, and that 1,000 calories is too low for most adolescents. The nurse should advise the students to eat enough calories to meet their energy and nutritional needs, and to avoid skipping meals or starving themselves.