When developing a plan of care for a patient with Guillain-Barre' syndrome, the nurse knows that which of the following nursing interventions would receive priority?
A) Using the incentive spirometer as prescribed
B) Maintaining the patient on bed rest
C) Assisting the patient with activities of daily living
D) Determining abnormalities of cognitive function
Ans: A
Feedback: Impaired gas exchange would be the priority. Respiratory function can be maximized with incentive spirometry and chest physiotherapy. Nursing interventions aimed at enhancing physical mobility and preventing a deep vein thrombosis are utilized. Assisting the patient with activities of daily living is important but would not be the priority nursing intervention. Guillain-Barre' does not affect cognitive function or level of consciousness.
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