Week 7 - Guillain-Barre Syndrome Flashcards
what is guillain-barre syndrome (GBS)
- acute, rapidly progressing, and potentially fatal form of paralysis
how does GBS manifest as (2)
- symmetrical, ascending paralysis
- demyelination of peripheral nerves –> eventually remyelinates
describe the prognosis of GBS
- with adequate supportive case and rehab, 85% of affected pts recover completely
what is GBS often precipitated by (3)
- infection (resp or GI usually)
- possible link between vaccination
- immunological response directed at peripheral nerves
describe the symptoms of GBS
- range from mild to severe
- progresses over hours, days, or lonher
what are symptoms of GBS (8)
- distal extremities effected most severely
- parasthesia –> paralysis
- hypotonia
- areflexia (no reflexes)
- pain
- autonomic nervous system dysfunction
- facial weakness
- dysphagia
severity varies among individuals
what signs of autonomic nervous system dysfunctions occur in GBS (4)
- CVS signs
- bowel and bladder dysfunction
- facial flushing
- diaphoresis
what CVS signs of autonomic nervous system dysfunction occur in GBS (5)
- orthostatic hypotension
- HTN
- bradycardia
- heart block
- asystole
describe the pain associated w GBS (5)
- secondary to neuropathy occurring
- muscle aches and cramps
- hyperaesthesias
- parasthesias
- worse at night
what impact can pain in GBS have (2)
- decreased appetite
- interfere w sleep
at what point are the symptoms of GBS most severe
- at 3rd week
describe the diagnosis of GBS (2)
- history
- S&S
what is the most serious complication of GBS
- resp failure –> if paralysis progresses to nerves that innervate the thoracic area
what nursing care should be done r/t the comp of resp failure in GBS
- constant monitoring of resp system
what are other complications associated w GBS (3)
- UTIs
- resp infections
- complications from immobility associated w paralysis
what is included in treatment/mngmt of GBS (4)
- plasmapheresis
- IVIG
- supportive care if systems
- nutritional therapy
what is included in supportive care of GBS (12)
- prophylaxis of DVT and PE
- monitor resp system
- monitor/prevent/treat infection
- support for fear and anxiety
- communication system if pt incapable & prevent isolation
- treatment for bladder retention
- PT
- facial paralysis –> eye care, artifical tears
- nutritional care
- bowel program (prevent constipation)
- pain assessment at least once daily
- turning schedule, skin assessments
what is included in care/mngmt of the resp system w GBS (6)
- focused resp assessment
- monitor ABGs
- monitor vital lung capacity
- chest physio to clear secretions
- possible tracheostomy, intubation, ventilation
- suctioning
how can nurses help relieve fear and anxiety in the pt & family (5)
- answer questions
- education
- keep informed
- reassure muscle function will return
- explain procedures
what is used for treatment of bladder retention associated w GBS
- intermittent cath preferred over indwelling (decreased r/o UTIs)
why is PT imp for a pt with GBS (3)
- do ROM and attention to body position
- help maintain function
- prevent contractures
what is included in nutritional care for a pt with GBS (4)
- assess gag reflex
- note any drooling or difficulties with secretions
- monitor fluid and electrolyte balance
- initially, tube feedings or parental nutrition may be used
if NG is being used for nutrition for a pt with GBS, what should be assessed at regular intervals and before feedings
- gastric residual volume
why is a pt with GBS at risk of constipation (3)
- immobility
- diet changes
- decreased GI motility
describe nutritional intake for pts with GBS
- may be compromised d/t dysphagia
how can mild dysphagia w GBS be managed (2)
- place pts in upright position
- flex head forward during meal times
how can severe dysphagia be mnged w GBS (2)
- tube feedings
- TPN (if experiencing paralytic ileus)
