For a patient who had a right hemisphere stroke, the nurse anticipates planning interventions to manage

For a patient who had a right hemisphere stroke, the nurse anticipates planning interventions to manage

A previously healthy 26-year-old male is brought to the emergency department due to muscle weakness. He reports mild weakness in his legs that has progressively worsened over a few days to the point that he can barely move his legs. He has some numbness in his legs and his arms feel weak. He has recently recovered from a respiratory infection. 1/5 muscle strength is noted throughout the lower extremities, as well as absent patellar and ankle reflexes. 3 to 4-/5 muscle strength is appreciated throughout his upper extremities. A lumbar puncture is performed, which shows the following: Cell count: 4 cells/mm3, Glucose: 67 mg/dL, Protein: 187 mg/dL Gram stain: no organisms Spirometry is performed, which shows a forced vital capacity of 0.85 L. Which of the following is the best next step in management?

A 37-year-old female with migraine without aura presents with headaches of increased frequency that typically begin in the morning. She says that zolmitriptan and acetaminophen are no longer effective in treating her episodes. In a month, she experiences approximately 20 days of headaches, and in the past 3 months, she has used zolmitriptan 15 times per month, on average, and acetaminophen at least 20 days per month. Medical history is significant for migraine and asthma. Medications are zolmitriptan, over the counter acetaminophen, and an albuterol inhaler. Which of the following is the next best step in management?

A 54-year-old male presents with difficulty in eating and drinking, and worsening hand-writing. This has been stressful for him as he has been continuously working on a novel that is due for publishing in a few weeks. He notes that alcohol improves his symptoms and relieves his stress. Medical history in noncontributory. Family history is significant for similar symptoms in his father, but cannot recall the name of the diagnosis. Physical examination shows a tremor of the hand, of medium frequency that worsens with his arms outstretched. Mild titubation is also noted on exam. Which of the following is the best initial treatment option for this patient?

A 62-year-old man presents with progressive proximal lower extremity muscle weakness. He reports difficulty with climbing the stairs and getting up from a chair. He also reports that his mouth has been constantly dry. These symptoms began approximately 3 weeks prior to presentation. Medical history is significant for recently diagnosed small cell carcinoma of the lungs. On physical examination, there is no evidence of muscle atrophy. There is 4/5 strength bilaterally in the hip flexors and extensors, with absent patellar reflexes. When asking the patient to contract both quadriceps for 10 seconds, his patellar reflexes become 2+. Which of the following is most likely to be found on serology?