• A history of a viral illness in the previous few weeks suggests the diagnosis.
Guillain-Barré Syndrome Diagnosis • Changes in vital capacity and negative inspiratory force are assessed to identify impending neuromuscular respiratory failure. • Evoked potential studies demonstrate a progressive loss of nerve conduction velocity.
Guillain-Barré Syndrome Diagnosis • Serum laboratory tests are not useful in the diagnosis. • However, elevated protein levels are detected in CSF evaluation, without an increase in other cells.
Guillain-Barré Syndrome Complications
Guillain-Barré Syndrome Complications Potential complications may include the following: Respiratory failure • The major cause of mortality • Changes in pulmonary vital capacity and negative inspiratory force • Bulbar weakness (involvement of cranial nerves IX, X, XI, XII) Autonomic dysfunction • Instability of cardiovascular system • Tachycardia, bradycardia, hypertension, or orthostatic hypotension
Guillain-Barré Syndrome Nursing Diagnoses
Guillain-Barré Syndrome Nursing Diagnoses • Ineffective breathing pattern and impaired gas exchange RT: rapidly progressive weakness and impending respiratory failure • Impaired bed and physical mobility RT: paralysis • Imbalanced nutrition: less than body requirements RT: inability to swallow • Impaired verbal communication RT: cranial nerve dysfunction • Fear and anxiety RT: loss of control and paralysis
Guillain-Barré Syndrome Management & Interventions
Guillain-Barré Syndrome Management • Because of the possibility of rapid progression and neuromuscular respiratory failure , Guillain-Barré syndrome is a medical emergency that may require management in an intensive care unit .
Guillain-Barré Syndrome Management • Respiratory therapy or mechanical ventilation may be necessary to support pulmonary function and adequate oxygenation.
Guillain-Barré Syndrome Management • Preventing the complications of immobility. • These may include the use of anticoagulant agents and sequential compression boots to prevent thrombosis and PE.
Guillain-Barré Syndrome Management • Plasmapheresis and Intravenous immunoglobulin (IVIG) are used to directly affect the peripheral nerve myelin antibody level. • Both therapies decrease circulating antibody levels and reduce the amount of time the patient is immobilized and dependent on mechanical ventilation.
Guillain-Barré Syndrome Management • Studies indicate that IVIG and plasmapheresis are equally effective in treating Guillain-Barré syndrome; however, IVIG is the therapy of choice because it is associated with fewer side effects when administered appropriately (Waterhouse, 2011).
Guillain-Barré Syndrome Management • Side effects of immunoglobulin (IVIG) therapy range from minor annoyances (e.g., chills, mild fever, myalgia, and headache) to major complications (e.g., anaphylaxis, aseptic meningitis, retinal necrosis, and acute kidney injury and failure).
Guillain-Barré Syndrome Management • The cardiovascular risks posed by
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- Myasthenia gravis