The nurse is reviewing the results of the client's echocardiogram and notes that the ejection fraction is 35%. The nurse anticipates that which of the following medications will be ordered to increase the client's cardiac output?

A. MS is a chronic autoimmune disorder affecting the central nervous system (CNS), specifically the brain and spinal cord. It typically presents with a wide range of neurological symptoms such as blurred vision, sensory disturbances, weakness, and difficulties with coordination and balance. However, MS does not typically present with a sudden onset of ascending numbness and weakness starting in the feet and moving upwards.
B. GBS is an acute autoimmune disorder where the immune system attacks the peripheral nervous system. It often starts with numbness, tingling, and weakness in the feet and legs, which then

progresses symmetrically upwards to involve the upper limbs and potentially affect respiratory muscles. This ascending pattern of weakness is characteristic of GBS, making it the most likely diagnosis in this scenario.
C. Myasthenia gravis is a chronic autoimmune disorder affecting neuromuscular junctions, leading to muscle weakness and fatigue, especially with repetitive use. It typically presents with fluctuating muscle weakness that worsens with activity and improves with rest. The pattern of ascending numbness and weakness seen in the scenario does not align with the typical presentation of myasthenia gravis.
D. Parkinson's disease is a progressive neurological disorder primarily affecting movement. It presents with symptoms such as tremors, bradykinesia (slowness of movement), rigidity, and postural instability. It does not typically cause numbness or a symmetrical ascending pattern of weakness as described in the scenario.

A. While GBS primarily affects peripheral nerves (nerves outside the brain and spinal cord), it does not typically cause direct degeneration of nerves in the brainstem and spinal cord. Therefore, this option is not correct in the context of respiratory distress in GBS.
B. Pleural effusion caused by immobility: Pleural effusion, an accumulation of fluid in the pleural cavity around the lungs, is not a typical complication of GBS. It is more commonly associated with conditions such as heart failure, pneumonia, or malignancy, rather than directly with GBS.
C. In Guillain-Barre Syndrome, demyelination of nerves affects the transmission of signals from the brain to the muscles, including those responsible for respiration. As a result, respiratory muscles may become weak or paralyzed, leading to shallow breathing and respiratory distress.
D. While respiratory distress can occur in some neurological conditions due to autonomic dysfunction or secondary complications, such as aspiration pneumonia, bronchoconstriction and airway edema are not typical manifestations of GBS itself.