When obtaining a fingerstick blood sugar, the practical nurse (PN) uses the lancet to prick the client's finger. After observing that a drop of blood is visible on the finger, which action should the PN take?

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.

Choice A reason: Initiating contact isolation precautions is not necessary for psoriasis. Psoriasis is not an infectious or contagious condition, so isolation is not required. The focus should be on managing symptoms and providing appropriate care to alleviate the client's discomfort.
Choice B reason: Explaining the need to keep the affected areas dry is not an appropriate action for psoriasis management. Psoriasis is characterized by dry, scaly patches of skin, and keeping the areas dry may worsen the condition. It is important to keep the skin moisturized and hydrated to reduce flaking and discomfort.
Choice C reason: Preparing the client for allergen testing is not relevant in this context. Psoriasis is an autoimmune condition, not an allergic reaction. Allergen testing is not typically used in the diagnosis or management of psoriasis. The focus should be on addressing factors that can exacerbate symptoms, such as stress, infections, and certain medications.
Choice D reason: Reviewing stress reduction strategies with the client is the most appropriate action. Stress is known to be a significant trigger for psoriasis flare-ups. By helping the client identify and implement stress reduction techniques, the PN can assist in managing the client's symptoms and improving their overall well-being. Techniques such as mindfulness, relaxation exercises, and counseling can be beneficial in reducing stress and minimizing psoriasis symptoms.