A nurse is caring for a client at an outpatient clinic. Click to highlight the findings that require follow-up. To deselect a finding, click on the finding again. Nurses' Notes 3 months ago: Middle-aged client reports experiencing fatigue for longer than 4 months. Reports struggling to remember things and feeling depressed. Intermittent hand tremors reported and sudden episodes of leg weakness during ambulation, causing a loss of balance and gait changes. Intermittent episodes of muscle spasms started about a month ago. Reports no falls. Average work week is 40 hr in their family-owned business but has had to reduce work to 20 hr a week during "episodes" lasting about 4 days when manifestations worsen significantly. These episodes occur about once a month. Client has 20/20 vision, but reports experiencing double vision "a couple of times." Last bowel movement was 1 day ago. Voids without difficulty but reports a feeling of "squeezing or spasm" in the genitourinary area that has only occurred a few times. No blood noted in urine. Height 162.6 cm (64 in) Weight 77.6 kg (171.1 lb) BMI 29.3 Vital Signs 3 months ago: Temperature 36.7° C (98.1° F) Heart rate 84/min Respiratory rate 16/min Blood pressure 124/82 mm Hg Oxygen saturation 97% on room air