The nurse is caring for a client diagnosed with Myasthenia Gravis (MG) who is post op thymectomy. The client problem is Ineffective Breathing Pattern, Which action would the nurse include in the plan of care?

A) "I agree. Sometimes the adverse effects can be worse than the disease":
While it's important for the nurse to acknowledge the client's concerns, making this statement may not be helpful in this situation. It could unintentionally reinforce fear and anxiety, implying that the chemotherapy's side effects may be worse than the disease itself, which is not always the case. Instead, the nurse should engage the client in a discussion to explore the specific concerns, allowing for tailored support and information.

B) "Someone from the American Cancer Society will be here soon to answer your questions":
While the American Cancer Society can provide valuable support and resources, referring the client to someone else to answer their questions can feel dismissive. The nurse should take the opportunity to listen to the client’s concerns and provide immediate reassurance or information. Direct involvement in the discussion builds trust and allows for more immediate emotional and psychological support.

C) "What is it about the adverse effects that concern you?":
This response is the most appropriate as it encourages the client to express their specific concerns. By asking the client to clarify their worries, the nurse can provide more accurate information, address misunderstandings, and offer reassurance. This open-ended question helps the nurse understand the client's emotions and individual needs, which allows for a more personalized approach in managing anxiety and providing education about the chemotherapy treatment.
D) "I will have your provider discuss the adverse effects with you before the treatment begins":
While it is important for the healthcare provider to discuss the treatment plan and potential side effects, the nurse should not defer the conversation entirely. The nurse plays an essential role in providing ongoing support, educating the client, and answering questions. The nurse can start the conversation and provide information about the common side effects of chemotherapy, offering the opportunity for further discussion with the provider as needed. Deferring the conversation might leave the client feeling unsupported.

A) Painful areas on the affected side following 3 branches of the nerve:
This is not typically a feature of Bell's Palsy. Bell's Palsy is primarily a motor dysfunction of the facial nerve (cranial nerve VII), leading to facial weakness. The pain associated with Bell's Palsy, if present, is usually mild and localized to the jaw, behind the ear, or along the jawline rather than along all three branches of the trigeminal nerve (cranial nerve V), which controls sensation in the face. Therefore, this choice is not consistent with the typical presentation of Bell's Palsy.

B) Decreased visual acuity when tested with Snellen Chart:
Decreased visual acuity is not a primary feature of Bell's Palsy. This condition specifically affects facial nerve function, which controls the muscles of facial expression, including those responsible for closing the eyes tightly. However, Bell's Palsy does not typically result in visual changes such as decreased visual acuity or problems with vision itself. Decreased vision would be more indicative of an issue with the optic nerve (cranial nerve II) or other eye-related conditions.

C) Unilateral upper and lower facial weakness including forehead:
This is the hallmark sign of Bell's Palsy. The facial nerve (cranial nerve VII) controls the muscles of the face, and when it becomes affected by Bell's Palsy, both the upper and lower parts of the face on one side can be weak or paralyzed. Importantly, Bell's Palsy causes inability to wrinkle the forehead, which distinguishes it from stroke, where the forehead is typically spared because the upper part of the facial muscles receives bilateral input from the brain. Thus, both upper and lower facial weakness, including inability to raise the eyebrow (forehead), is characteristic of Bell's Palsy.

D) Facial dropping, with arm and leg weakness on the affected side:
Facial drooping is a common symptom of Bell's Palsy, but arm and leg weakness is not associated with it. Arm and leg weakness on the same side would be more suggestive of a stroke affecting the cerebrovascular system, rather than a peripheral nerve issue like Bell's Palsy. Bell's Palsy is confined to facial nerve dysfunction and does not cause weakness in the limbs.