A nurse is assessing a client who has Guillain-Barre syndrome. Which finding should the nurse expect?

• A. Weakness of the lower extremities
• B. Rapid mood changes
• C. Persistent fever
• D. Hyperreflexia

Answer: (A)

Guillain-Barre syndrome causes an acute demyelinating process of the peripheral nerves that typically begins with weakness in the legs and rapidly ascends. You’d expect to see weakness in the lower extremities as the initial and most characteristic sign, which may progress to involve the arms and trunk and can affect respiratory muscles. A hallmark accompanying this pattern is decreased or absent deep tendon reflexes (hyporeflexia/areflexia), not hyperreflexia.

Rapid mood changes are not a feature of this peripheral neuropathy and fever is not a defining finding of the neuromuscular presentation (infection can trigger GBS, but a persistent fever isn’t the pattern). Hyperreflexia suggests central nervous system involvement, which is not how Guillain-Barre presents. So the finding most consistent with this condition is weakness starting in the lower extremities.