Which statement describes a hallmark feature of Guillain-Barré syndrome and a major nursing concern?

• A. Rapidly progressive symmetric weakness with areflexia
• B. Focal weakness with preserved reflexes
• C. Progressive cognitive decline
• D. Seizures

Answer: (A)

Guillain-Barré syndrome presents with rapidly progressive symmetric weakness paired with areflexia. The weakness typically begins in the legs and ascends upward, and reflexes become diminished or absent as the peripheral nerves become inflamed. This peripheral nerve involvement makes respiratory compromise the major nursing concern, because weakness of the diaphragm and intercostal muscles can lead to respiratory failure. Therefore, close respiratory monitoring is essential—watch for decreasing tidal volume and vital capacity, monitor oxygen saturation, and be prepared for possible intubation or ventilatory support. Autonomic instability, such as fluctuations in blood pressure and heart rate, adds another layer of risk, so continuous cardiovascular monitoring is important, along with assessment for swallowing difficulties to prevent aspiration and ensure safe nutrition. The other descriptions don’t fit because focal weakness with preserved reflexes suggests a localized CNS process, while progressive cognitive decline or seizures point to brain involvement rather than a peripheral demyelinating neuropathy.