The nurse anticipates which of the following medications to be ordered for a patient in the later stages of Huntington's Disease (HD)?

A. Remove the chest tube and cover the incision site with a sterile petrolatum gauze: Removing the chest tube is not appropriate for transporting the patient to the x-ray department. The chest tube is essential for draining air, blood, or fluid from the pleural space and preventing complications like pneumothorax or fluid buildup. Removing it could cause harm and disrupt the treatment.

B. Disconnect the drainage system covering the catheter tip with sterile gauze: Disconnecting the drainage system is not recommended as it could cause the re-accumulation of air or fluid in the pleural space and compromise the patient's condition. The chest tube should remain connected to the drainage system to ensure continued drainage and prevent complications.

C. Send the client to x-ray with the chest tube clamped: Clamping a chest tube is not recommended unless specifically directed by a healthcare provider (such as during certain procedures or trials). Clamping can lead to dangerous complications, such as a tension pneumothorax, by preventing proper drainage of air or fluid. Therefore, the chest tube should not be clamped during transport.

D. Send the client to x-ray with the chest tube attached to the drainage system: This is the correct answer. The chest tube should remain attached to the drainage system during transport to ensure continuous drainage of air or fluid from the pleural space, which is vital for the patient's stability. The drainage system should be securely positioned to avoid kinks or disconnections, and the chest tube should remain open to prevent complications.

A. Difficulty swallowing and speaking associated with descending muscle weakness: Amyotrophic lateral sclerosis (ALS) primarily affects motor neurons, leading to progressive muscle weakness. Difficulty swallowing (dysphagia) and speaking (dysarthria) are common symptoms, and these occur as the muscle weakness affects the tongue, throat, and other muscles responsible for these functions. The weakness typically starts in the limbs and then progresses to involve other areas of the body.

B. Movement and behavioral unpredictability with declining cognitive abilities: While ALS primarily affects motor function, some patients may experience mild cognitive changes or frontotemporal dementia (FTD), but this is not a characteristic feature for most individuals. Behavior and cognitive decline are not typically seen in the majority of ALS cases.

C. Muscle weakness starting in bilateral legs with weakness ascending upwards: This description is more consistent with Guillain-Barré Syndrome (GBS), which often presents with ascending muscle weakness that starts in the lower limbs. In ALS, muscle weakness generally starts in one area (e.g., a limb) and progresses asymmetrically, rather than ascending in a symmetrical pattern.

D. Ptosis, fatigue, and generalized muscle weakness: Ptosis (drooping eyelids) is not a primary or common symptom of ALS. While generalized muscle weakness and fatigue are common in ALS, ptosis is more characteristic of other neuromuscular disorders such as myasthenia gravis.