205) ANSWER
C) Increasing hoarseness
RATIONALE
Guillain-Barré syndrome is an ascending paralysis. While the child will have increasingly less muscle tone in the extremities, the hoarseness could indicate involvement in the muscles of respiration. Serious concern is raised when the respiratory muscles are affected. Sometimes mechanical ventilation is indicated. Tingling is a common sign of Guillain-Barré and not related to respiratory distress. Consider which option can have serious implications. Knowledge of Guillain-Barré as an ascending paralysis would indicate that hoarseness would be an impending sign of difficulty.
C) Increasing hoarseness
RATIONALE
Guillain-Barré syndrome is an ascending paralysis. While the child will have increasingly less muscle tone in the extremities, the hoarseness could indicate involvement in the muscles of respiration. Serious concern is raised when the respiratory muscles are affected. Sometimes mechanical ventilation is indicated. Tingling is a common sign of Guillain-Barré and not related to respiratory distress. Consider which option can have serious implications. Knowledge of Guillain-Barré as an ascending paralysis would indicate that hoarseness would be an impending sign of difficulty.
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