A nurse is assessing a client who has a left lower arm fracture. Which of the following findings indicates impaired venous return in the client’s affected arm?

The correct answer is: c. Prepare the client for intubation.

Choice A: Prepare to administer a vasopressor

Reason: Vasopressors are typically used to manage hypotension (low blood pressure) and are not a standard treatment for myasthenic crisis. Myasthenic crisis primarily involves respiratory muscle weakness, which can lead to respiratory failure, rather than issues with blood pressure.

Choice B: Administer an anticholinesterase medication

Reason: While anticholinesterase medications like pyridostigmine are used to manage myasthenia gravis, they are generally not recommended during a myasthenic crisis. During a crisis, the focus is on stabilizing the patient, often requiring more immediate interventions such as intubation and mechanical ventilation.

Choice C: Prepare the client for intubation

Reason: Intubation is a critical intervention in a myasthenic crisis due to the risk of respiratory failure. The crisis is characterized by severe muscle weakness, including the muscles that control breathing. Intubation ensures that the airway is protected and that the patient can receive adequate ventilation.

Choice D: Instruct the client to perform pursed lip breathing

Reason: Pursed lip breathing is a technique used to improve breathing efficiency in conditions like chronic obstructive pulmonary disease (COPD). However, it is not appropriate for managing a myasthenic crisis, where the primary issue is severe muscle weakness leading to respiratory failure.

Choice A reason: Tingling in the arms can occur due to nerve compression caused by the herniated disc. This is a common symptom known as radicular pain, which can radiate from the neck down to the arms and hands.

Choice B reason: Shoulder pain is another expected finding, as the nerves affected by a cervical herniated disc can cause pain to radiate into the shoulders.

Choice C reason: Muscle spasms may be a reflexive response to the pain and inflammation caused by the herniated disc, as the body attempts to stabilize the affected area.

Choice D reason: A stiff neck can result from the muscle tension and reduced range of motion due to the pain and inflammation associated with a herniated cervical disc.

Choice E reason: Low back pain is not typically associated with a herniated cervical disc, as cervical discs are located in the neck region. Low back pain would be more indicative of a lumbar spine issue.