How many milligrams of carbidopa is this patient taking per dose/tablet?

A) Unilateral upper extremity weakness:
Guillain-Barré Syndrome (GBS) typically presents with bilateral weakness, not unilateral. The weakness in GBS typically begins symmetrically in the lower extremities and ascends upward toward the upper body, including the arms, face, and respiratory muscles. Therefore, unilateral weakness is not characteristic of GBS, and its presence should prompt further investigation into other possible causes.

B) Bilateral ascending weakness:
One of the hallmark signs of Guillain-Barré Syndrome is ascending weakness, which means that the weakness usually starts in the lower extremities (legs) and progresses upwards to the upper extremities, face, and potentially the respiratory muscles. This bilateral ascending paralysis is a classic feature of GBS and occurs due to the immune system attacking the myelin sheath of peripheral nerves. The nurse should be vigilant for signs of progressive weakness, as GBS can quickly lead to respiratory failure and requires prompt intervention.

C) Mask-like facial expressions:
Mask-like facial expressions are more commonly associated with Parkinson's disease, not Guillain-Barré Syndrome. Parkinson’s disease is characterized by a reduction in facial expressiveness due to the loss of dopaminergic neurons, leading to a fixed, unblinking, or "masked" appearance. While facial involvement can occur in GBS as the weakness ascends, it is not typically described as a "mask-like" expression.

D) Pill rolling actions made by the client's fingers:
Pill-rolling is a characteristic tremor often associated with Parkinson's disease and involves the repetitive motion of the fingers, as if rolling a pill. It is a resting tremor seen in Parkinson's disease and not in Guillain-Barré Syndrome. GBS primarily presents as weakness and loss of motor function, rather than tremors or other involuntary movements.

A) Take the medication with meals:
Inhaled beclomethasone is a corticosteroid, and it is generally not necessary to take it with meals. Oral corticosteroids are sometimes taken with meals to minimize gastric irritation, but this does not apply to inhaled corticosteroids like beclomethasone. The primary concern with inhaled corticosteroids is not related to meal timing but to oral hygiene to prevent side effects like oral thrush.

B) Limit caffeine intake:
There is no direct contraindication or requirement to limit caffeine intake when taking inhaled beclomethasone. While caffeine can have mild bronchodilatory effects, it does not interfere with the action of beclomethasone or exacerbate asthma symptoms. This is not a priority teaching point for the patient.

C) Rinse the mouth after administration:
One of the most important teaching points when using inhaled beclomethasone is to rinse the mouth after each use. This helps to prevent oral thrush (a fungal infection caused by Candida), which is a common side effect of inhaled corticosteroids. Rinsing the mouth with water after administration helps to remove any leftover medication and reduce the risk of infection, making this the most important instruction.

D) Check the pulse before and after medication administration:
While checking the pulse is important for some medications, such as bronchodilators like albuterol, it is not necessary for inhaled beclomethasone. Beclomethasone is a corticosteroid that primarily works by reducing inflammation in the airways, and it does not have a significant impact on heart rate. Therefore, it is not required to monitor pulse before and after its use.