Patients first notice tingling in the feet or hands, then rapid (hours‑to‑days) progression to proximal muscles. Weakness ascends predictably: lower limbs → trunk → upper limbs → facial and bulbar muscles. Deep‑tendon reflexes become absent. Approximately 30 % develop respiratory insufficiency, and 70 % exhibit autonomic dysfunction such as blood‑pressure lability or sinus tachycardia. Early cranial‑nerve involvement (facial diplegia, ophthalmoplegia) suggests a more severe course. Clinical trajectory check Link new findings to the underlying process and the compensatory response that is succeeding or failing. Reassess objective trends such as perfusion, oxygenation, mental status, pain pattern, labs, and response to time-limited interventions so the next action reflects improvement or deterioration rather than a memorized label. Clinical trajectory check Link new findings to the underlying process and the compensatory response that is succeeding or failing. Reassess objective trends such as perfusion, oxygenation, mental status, pain pattern, labs, and response to time-limited interventions so the next action reflects improvement or deterioration rather than a memorized label. For NCLEX-RN (Canada), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory,...