Guillain Barre

Question 1

Definition

Answer 1

Acute inflammatory polyradioloneuropathy that affects the axons or myelin of the peripheral nervous system, causing motor and sensory abnormalities

Question 2

Ascending paralysis

Answer 2

Starts at the toes and works its way up

Question 3

Associated with

Answer 3

Campylobacter jejuni
Influenza
Epstein-Barr
Cytomegalovirus

Question 4

Not sufficient to establish a diagnosis, but often reported….

Answer 4

Surgery
Trauma
Pregnancy
Vaccines

Question 5

Healing occurs in reverse

Answer 5

Neurons affected last are the first to recover

Question 6

Acute period

Answer 6

1-4 weeks

Question 7

Plateau period

Answer 7

Several days to 2 weeks

Question 8

Recovery phase

Answer 8

4-6 months or 2 years

Question 9

Motor manifestations

Answer 9

Ascending symmetric muscle weakness
Decreased or absent DTR
Respiratory compromise 
Loss of bowel:bladder control
Ataxia

Question 10

Sensory manifestations

Answer 10

Paresthesias

Pain

Question 11

Cranial nerve manifestations

Answer 11

Facial weakness
Dysphagia
Diplopia
Difficulty speaking

Question 12

Autonomic manifestations

Answer 12

Labile blood pressure
Cardiac dysrhythmias
Tachycardia

Question 13

Cranial nerves to check

Answer 13

5
7
10
11
12
9

Question 14

Lumbar puncture

Answer 14

Increased protein
May not show until 1-2 weeks
Peaks after 4-6 weeks
Normal lymphocyte

Question 15

Electrophysiologic studies

Answer 15

Electrical conduction of heart shows demylunated neuropathy

Question 16

Electromyographic

Answer 16

Peripheral nerve function

Normal early, abnormal 4-6 weeks later

Question 17

Priority nursing care

Respiratory

Answer 17

Suction at bedside
Swallowing?
Drooling?
HOB 45

Question 18

Pain management

Answer 18

Opioid
Tricyclics
Gabapentin
CAM therapies

Question 19

CT and MRI

Answer 19

Rule out other possibilities

Question 20

Treatment

Answer 20

Plasmapheresis
OR
Immunoglobulin IV

Question 21

Plasmapheresis

Answer 21

Removes circulating antibodies blamed

Question 22

Immunoglobulin therapy

Answer 22

Just as effective
May cause
Fever, chills, HA
Meningitis, anaphylaxis

Question 23

Complications of plasmapheresis

Answer 23

Hypocalcemia
Depleted coagulopathy
Infection 
Hypovolemia
Anaphlaysis 
Clotting at site 
Bleeding