What assessment finding would indicate the patient's left-sided heart failure is worsening?

Choice A rationale

Myasthenia gravis is an autoimmune neuromuscular disorder characterized by weakness and fatigue of the skeletal muscles. Improvement of ptosis after administration of edrophonium (Tensilon), a short-acting acetylcholinesterase inhibitor, is a diagnostic indicator of myasthenia gravis.

Choice B rationale

Cerebral palsy is a group of permanent movement disorders that appear in early childhood. It is primarily caused by abnormal development or damage to the brain and does not exhibit rapid improvement with edrophonium.

Choice C rationale

Multiple sclerosis is a chronic illness involving the central nervous system, where the immune system attacks the protective sheath (myelin) that covers nerve fibers. It does not respond to edrophonium as myasthenia gravis does.

Choice D rationale

Muscle spasm refers to an involuntary contraction of a muscle that can be sudden and painful. This condition is not typically diagnosed or treated with edrophonium, which is specific for myasthenia gravis. .

Choice A rationale

This choice is correct. The side effects of paroxetine, including headaches, nervousness, and poor appetite, are common during the initial weeks of treatment and often decrease over time as the patient’s body adjusts to the medication. Reassuring the patient helps them continue the treatment without undue anxiety about these side effects, which are typically transient and manageable.

Choice B rationale

This choice is incorrect. Abruptly stopping paroxetine without consulting a healthcare provider is not recommended because it can lead to withdrawal symptoms and a possible relapse of depression or anxiety. The patient should only discontinue the medication under the guidance of a healthcare provider, who may suggest a gradual tapering off process to minimize withdrawal symptoms.

Choice C rationale

This choice is partially correct. Taking paroxetine with food can help mitigate some gastrointestinal side effects, such as nausea. However, it does not directly address headaches, nervousness, or poor appetite. Although taking the medication with food is a useful tip, it is not the most comprehensive advice for this particular situation.

Choice D rationale

This choice is incorrect. While adjusting the dose may be an option, it is premature to suggest this after only two weeks of treatment. The patient’s body may still be adjusting to the medication, and many side effects diminish with time. The decision to change the dosage should be made by the healthcare provider based on a thorough evaluation of the patient’s response to the treatment.