Chapter 65: Guillian-Barre Syndrome Flashcards
A 55-year-old male presents to the emergency department with progressive weakness in both legs that started three days ago. He reports having an upper respiratory infection two weeks ago. The nurse notes diminished deep tendon reflexes in the lower extremities and mild paresthesia. Based on the patient’s history and clinical presentation, which patient characteristic places him at the highest risk for developing Guillain-Barré Syndrome (GBS)?
A. History of bacterial or viral infection a few weeks prior
B. Being under the age of 30
C. Family history of autoimmune disorders
D. Recent exposure to environmental toxins
A. History of bacterial or viral infection a few weeks prior
Rationale: GBS is an autoimmune process that occurs a few days or weeks after a viral or bacterial infection. This is a hallmark characteristic of the disorder.
The nurse is caring for a 65-year-old patient with Guillain-Barré Syndrome (GBS) who has been diagnosed with acute inflammatory demyelinating polyneuropathy (AIDP). Which statement by the nurse accurately describes this type of GBS?
A. “This type of GBS is more common in children and affects motor function only.”
B. “This is the most common type of GBS and involves damage to the myelin sheath.”
C. “This form of GBS primarily affects sensory nerves and is less severe than other types.”
D. “This type of GBS causes rapid brainstem involvement and leads to seizures.”
B. “This is the most common type of GBS and involves damage to the myelin sheath.”
Rationale: The most common type of GBS is acute inflammatory demyelinating polyneuropathy (AIDP), which involves damage to the myelin sheath surrounding peripheral nerves.
A nurse is educating a patient diagnosed with Guillain-Barré Syndrome (GBS) about the different subtypes of the disease. Which statement by the patient indicates a need for further teaching?
A. “Acute inflammatory demyelinating polyneuropathy is the most common type of GBS.”
B. “Children are more likely to develop acute motor axonal neuropathy than adults.”
C. “Guillain-Barré Syndrome is a common neurological disorder, affecting millions of people worldwide.”
D. “The cause of GBS is often linked to an infection that occurred a few weeks before symptoms began.”
C. “Guillain-Barré Syndrome is a common neurological disorder, affecting millions of people worldwide.”
Rationale: GBS is a rare disorder, affecting approximately 1 person in every 100,000. This makes option C incorrect. The other statements are accurate: AIDP is the most common type (A), AMAN is more common in children (B), and GBS often follows a viral or bacterial infection (D).
A nurse is reviewing information about Guillain-Barré Syndrome (GBS). Which of the following statements are accurate about the disorder? (SATA)
A. GBS is an autoimmune process that occurs after a bacterial or viral infection.
B. It is more commonly seen in individuals under the age of 30.
C. The most common type of GBS is acute inflammatory demyelinating polyneuropathy (AIDP).
D. AMAN, a type of GBS, is more commonly seen in children.
E. GBS is a rapidly progressive disease that primarily affects the central nervous system.
A. GBS is an autoimmune process that occurs after a bacterial or viral infection.
C. The most common type of GBS is acute inflammatory demyelinating polyneuropathy (AIDP).
D. AMAN, a type of GBS, is more commonly seen in children.
Rationale:
* A (Correct): GBS is an autoimmune process that typically occurs after a viral or bacterial infection.
- B (Incorrect): GBS can occur at any age, but those over age 50 are at greatest risk.
- C (Correct): The most common type of GBS is acute inflammatory demyelinating polyneuropathy (AIDP).
- D (Correct): Acute motor axonal neuropathy (AMAN) is more common in children.
- E (Incorrect): GBS primarily affects the peripheral nervous system, not the central nervous system.
A 52-year-old patient presents to the clinic with progressive muscle weakness that started in the legs and is now affecting the arms. The patient states that they had a bacterial infection two weeks ago. The nurse suspects Guillain-Barré Syndrome (GBS). Which of the following findings best supports this diagnosis?
A. Gradual onset of weakness over several months
B. Hyperactive deep tendon reflexes in the lower extremities
C. Weakness that begins in the upper extremities and spreads downward
D. Recent infection followed by ascending muscle weakness
D. Recent infection followed by ascending muscle weakness
Rationale: GBS is an autoimmune process that occurs after a bacterial or viral infection and is characterized by ascending muscle weakness (starting in the legs and progressing upward).
A 47-year-old male presents to the clinic with progressive muscle weakness and numbness in his lower extremities. His medical history includes a recent episode of Campylobacter jejuni gastroenteritis. The provider suspects Guillain-Barré Syndrome (GBS). Based on the patient’s history, which subtype of GBS is most likely?
A. Acute inflammatory demyelinating polyneuropathy (AIDP)
B. Acute motor axonal neuropathy (AMAN)
C. Acute motor-sensory axonal neuropathy (AMSAN)
D. Chronic inflammatory demyelinating polyneuropathy (CIDP)
B. Acute motor axonal neuropathy (AMAN)
Rationale: Campylobacter jejuni gastroenteritis is the most common bacterial cause of AMAN, a subtype of GBS that primarily affects the nerve axons rather than the myelin sheath.
A nurse is educating a group of nursing students about the pathophysiology of Guillain-Barré Syndrome (GBS). Which statement by a student indicates a correct understanding of the disease process?
A. “GBS results from a known genetic mutation affecting nerve conduction.”
B. “The immune system attacks the myelin sheath or nerve axons, leading to paralysis.”
C. “GBS is caused by direct viral invasion of the peripheral nervous system.”
D. “Muscle atrophy in GBS occurs due to a permanent loss of nerve function.”
B. “The immune system attacks the myelin sheath or nerve axons, leading to paralysis.”
Rationale: GBS is an autoimmune disorder where the immune system attacks either the myelin sheath (AIDP) or nerve axons (AMAN), resulting in flaccid paralysis and muscle denervation.
Which of the following best describes the recovery process in Guillain-Barré Syndrome (GBS)?
A. Remyelination occurs quickly in a distal-to-proximal pattern.
B. Recovery is often incomplete, with permanent neurological deficits.
C. Remyelination occurs slowly, with neurological function returning in a proximal-to-distal pattern.
D. The nervous system compensates by regenerating new nerve fibers.
C. Remyelination occurs slowly, with neurological function returning in a proximal-to-distal pattern.
Rationale: During recovery, remyelination occurs slowly, and neurologic function returns in a proximal-to-distal pattern (opposite of the initial progression of symptoms).
A nurse is reviewing the potential triggers of Guillain-Barré Syndrome (GBS) with a patient. Which recent event in the patient’s history would be most concerning?
A. Diagnosis of cytomegalovirus infection
B. History of seasonal allergies
C. Recent mild dehydration
D. Exposure to secondhand smoke
A. Diagnosis of cytomegalovirus infection
Cytomegalovirus is the most common viral cause of GBS, making this infection a major concern in a patient at risk for developing the disorder.
A nurse is educating a patient about infections that can lead to Guillain-Barré Syndrome (GBS). Which of the following infections are known triggers of GBS? (SATA)
A. Mycoplasma pneumoniae
B. Haemophilus influenzae
C. Hepatitis A, B, and E
D. Varicella-zoster virus
E. Epstein-Barr virus
A. Mycoplasma pneumoniae
B. Haemophilus influenzae
C. Hepatitis A, B, and E
E. Epstein-Barr virus
A 35-year-old female recovering from a viral upper respiratory infection presents with progressive muscle weakness and reports difficulty walking. Her deep tendon reflexes are absent. The provider suspects Guillain-Barré Syndrome (GBS). The nurse knows that which pathophysiologic process is occurring?
A. Direct infection of the peripheral nerves by the virus
B. Inflammatory destruction of the myelin sheath or axons
C. Spinal cord demyelination leading to muscle weakness
D. Impaired cerebral blood flow causing neurological deficits
B. Inflammatory destruction of the myelin sheath or axons
Rationale: GBS occurs due to immune-mediated inflammation that damages the myelin sheath (AIDP) or axons (AMAN), leading to muscle weakness and paralysis.
Which of the following statements accurately describes the impact of Guillain-Barré Syndrome (GBS) on nerve impulse transmission?
A. Nerve impulses continue unaffected, but muscle contraction is impaired.
B. Synaptic transmission between neurons in the brain is disrupted.
C. Spinal cord lesions block all peripheral nerve signals.
D. Nerve transmission is slowed or stopped due to demyelination or axonal damage.
D. Nerve transmission is slowed or stopped due to demyelination or axonal damage.
Rationale: GBS causes segmental loss of the myelin sheath or direct axonal damage, leading to slowed or blocked nerve impulse transmission, resulting in flaccid paralysis.
A nurse is discussing potential non-infectious triggers of Guillain-Barré Syndrome (GBS) with a patient. Which of the following could also contribute to the development of GBS?
A. Vitamin B12 deficiency
B. Chronic exposure to heavy metals
C. Prolonged corticosteroid use
D. Recent surgery or trauma
D. Recent surgery or trauma
Rationale: In addition to infections, surgery and trauma have been identified as potential triggers for GBS, likely due to their impact on immune system activation.
A 42-year-old male presents to the emergency department with progressive weakness and tingling in both legs over the past week. His examination reveals hypotonia and absent deep tendon reflexes in the lower extremities. The patient denies recent trauma but reports a viral illness two weeks ago. Based on these findings, which additional assessment should the nurse prioritize?
A. Assess for bowel and bladder dysfunction
B. Monitor for facial weakness and dysphagia
C. Evaluate respiratory rate and depth
D. Check for orthostatic hypotension
C. Evaluate respiratory rate and depth
Rationale: The most serious complication of GBS is respiratory failure due to paralysis progressing to the thoracic muscles. Assessing respiratory rate and depth is critical to determine if immediate intervention (e.g., intubation, mechanical ventilation) is required.
A nurse is assessing a patient diagnosed with acute inflammatory demyelinating polyneuropathy (AIDP). Which neurological symptom should the nurse anticipate?
A. Descending muscle weakness starting in the arms
B. Asymmetric limb weakness progressing over several months
C. Acute, ascending, symmetric limb weakness
D. Progressive weakness with spasticity and hyperreflexia
C. Acute, ascending, symmetric limb weakness
Rationale: The hallmark of GBS, particularly AIDP, is acute, rapidly progressive, ascending, symmetric limb weakness. It typically starts in the lower extremities and progresses upward.
A patient with Guillain-Barré Syndrome (GBS) develops sudden bradycardia and episodes of asystole. The nurse recognizes that this is due to:
A. Damage to the phrenic nerve
B. Autonomic nervous system dysfunction
C. Progressive muscle atrophy
D. Increased intracranial pressure
B. Autonomic nervous system dysfunction
Rationale: Patients with AIDP and AMSAN subtypes of GBS often experience autonomic dysfunction, leading to abnormal vagal responses such as bradycardia, heart block, and asystole.
A 50-year-old female with GBS reports severe muscle cramps and burning pain in her legs, which worsens at night. Which intervention should the nurse implement first?
A. Administer an opioid analgesic
B. Provide a muscle relaxant
C. Reposition the patient for comfort
D. Assess pain level and characteristics
D. Assess pain level and characteristics
Rationale: Pain in GBS can present as paresthesia, muscular cramps, or hyperesthesia and is often worse at night. Before treatment, the nurse must assess pain level, location, and characteristics to ensure appropriate intervention.
A nurse is educating a group of nursing students about autonomic dysfunction in Guillain-Barré Syndrome (GBS). Which of the following clinical manifestations are associated with autonomic dysfunction in GBS? (SATA)
A. Hypertension
B. Facial flushing
C. Urinary retention
D. Spasticity
E. Hyperactive deep tendon reflexes
A. Hypertension
B. Facial flushing
C. Urinary retention
Rationale:
- A. Hypertension – Autonomic dysfunction in GBS can cause hypertension or orthostatic hypotension.
- B. Facial flushing – A common autonomic symptom.
- C. Urinary retention – Bowel and bladder dysfunction are complications of GBS.
- D and E (Incorrect): GBS causes flaccid paralysis, hypotonia, and absent reflexes, not spasticity or hyperactive reflexes.
A nurse is caring for a patient with GBS who is immobile due to paralysis. The nurse should monitor the patient for which complications related to immobility?
A. Increased intracranial pressure and seizures
B. Paralytic ileus, venous thromboembolism, and pressure injuries
C. Chorea, dystonia, and muscle hyperreflexia
D. Hyperthermia and severe diaphoresis
B. Paralytic ileus, venous thromboembolism, and pressure injuries
Rationale:
Due to paralysis and immobility, patients with GBS are at risk for:
* Paralytic ileus (due to loss of autonomic control)
* Venous thromboembolism (VTE) (due to lack of movement)
* Pressure injuries (PIs) (due to prolonged immobility)
A patient with GBS has absent deep tendon reflexes in all extremities. What is the underlying cause of this finding?
A. Increased intracranial pressure affecting spinal nerves
B. Demyelination of peripheral nerves affecting impulse conduction
C. Cerebral edema causing upper motor neuron dysfunction
D. Chronic muscle atrophy leading to reflex loss
B. Demyelination of peripheral nerves affecting impulse conduction
Rationale: GBS results in segmental demyelination, which disrupts nerve impulse transmission, leading to flaccid paralysis and absent reflexes.
