Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
GUILLAIN-BARRE
1. WHAT IS IT? |
1.Gullain-Barre is an autoimmune attack of the peripheral nerve myelin
|
|
|
GUILLAINE-BARRE
1. WHAT IS THE PATHOPYSIOLOGY? |
1. It is an acute inflammatory demyelinating disorder of the peripheral nervous system
-Destroys the myelin sheaths -results in poor conduction of nerve impulses -symmetric muscle weakness initially in lower extremities |
|
|
GUILLAINE-BARRE
1. WHAT IS A MYELIN SHEATH |
1. Myelin sheath covers the axons of the peripheral nerves providing insulation and speeding the conduction of impulses from the cell body to the dendrites. B&S
|
|
|
GUILLAIN-BARRE
1. WHAT IS THE CAUSE? |
1. It appears to be caused by a predisposing event, usually a viral infection 2 weeks prior to the onset of the symptoms.
-flu vaccine is thought to be a factor but has no supported data. |
|
|
GUILLAIN-BARRE
1. WHAT ARE SOME VIRAL INFECTIONS THAT TO CAUSE (GB)? |
1.Viral infections that to cause GB
-Ebsein-Barr -cytomegalovirus -Mycoplasma pneumonia -H. influenza -HIV -Campylobacter jejuni |
|
|
GUILLAIN-BARRE
1. IS (GB) SEEN IN ONE GENDER MORE THAN ANOTHER? |
1. Yes, (GB) is usually seen in men > women
|
|
|
GUILLAIN-BARRE
1. WHAT IS THE LIKELIHOOD OF FULLY RECOVERY/PARTIAL RECOVERY/DEATH |
1. Most patients 75-85% fully recover; 10% have residual disability; 5% die
|
|
|
GUILLAIN-BARRE
1.WHAT IS ONE MEDICAL)CONTRIBUTING FACTOR WHY MOST PATIENTS RECOVERY? |
1. Most patients recover because the Schwann cell (that produces myelin) is spared and allows for remyelination in the recovery phase of the disease.
|
|
|
GUILLAIN-BARRE
1. WHAT ARE THE STAGES OF THE ILLNESS? |
1. ACTUE STAGE
2. PLATEAU STAGE 3. RECOVERY STAGE |
|
|
GUILLAIN-BARRE
1. WHAT PATH DOES THE WEAKNESS USUALLY BEGIN? |
1. In Guillain-Barre the progression of weakness (paralysis)is ascending bilaterally & symetrically starting from the legs.
|
|
|
GUILLAIN-BARRE
(ACUTE STAGE) -CLINICAL MANIFESTAIONS (S&S) |
-Severe & rapid weakness in lower extremities (doesn't have to be sever & rapid, depends on the course the disease is taking)
-Loss of muscle strength -Quadriplegia & respiratory failure (in extreme cases) -Decreasing DTR -Paresthesias & Numbness (tingling/pain). -Facial muscle involvement -Autonomic nervous system involvement a) Bradycardia, urinary retention, sweating, BP all over the place, palpations, impaired mobility (watch for skin breakdown) |
|
|
GUILLAIN-BARRE
1. WHAT SHOULD BE OF CONCERN WITH A PATIENT WHO HAS 1. FACIAL MUSCLE INVOLVEMENT 2. PARESTHESIAS & NUMBNESS 3. IMMOBILITY A) NURSING INTERVENTIONS |
1. With facial muscle involvement should be concerned if they can't move their eyes (blink)
a) patch eyes at night, apply eye drops. 2. A patient with paesthesias and numbness can have a burning sensation and have pain a) pain medication/morphine 3. Patient who is immobile is at risk for impaired gas exchange, thrombophlebitis, skin breakdown, poor nutrition(with impaired swallowing/no gag reflex) a) DB&C, postural drainage, CPT, IS, mechanical vent,positive pressure b) turn q 2H, skin assessment, anticoagulants c) mouth care, NG feedings if no gag reflex, if relex elevate HOB d) stool softener, high fiber diet |
|
|
GUILLAIN-BARRE
(ACUTE STAGE) 1. HOW LONG DOES THIS STAGE USUALLY LAST? |
1. The acute stage last for approximately 1month.
|
|
|
GUILLAIN-BARRE
1. WHAT IS THE PRIORITY CONCERN OF A PATIENT WITH (GB)? |
1. The biggest concern with a pt. with GB is ABC's
A) Support airway and provide mechanical ventilation and O2 if needed. |
|
|
GUILLAIN-BARRE
1. DOES THE ILLNESS HAVE AN IMPACT ON THE PATIENT'S COGNITION OR LEVEL OF CONSCIOUSNESS? |
1. No
|
|
|
GUILLAIN-BARRE
(DIAGNOSIS) 1. HOW IS (GB) DIAGNOSED? |
Diagnosis is from compiling symptoms.
1.Symmetrical weakness 2.Diminished reflexes 3. upward progression of motor weakness 4.Hx of viral illness in the last few weeks 5. Changes in vital capacity 6. Elevated CSF without an increase in other cells. |
|
|
GUILLAIN-BARRE
(PLATEAU STAGE) 1. WHEN DOES THIS STAGE START? 2. HOW LONG IS THE PATIENT USUALLY IN THIS STAGE? 3. WHAT HEALTH PATTERNS CAN BE SEEN DURING THIS STAGE? |
1. The plateau stage is approximately 2wks after the acute stage
2. The plateau stage usually last for 4 weeks. 3. The patients symptoms start to level; ANS symptoms start to stabilize. |
|
|
GUILLIAN-BARRE
(RECOVERY STAGE) 1. HOW LONG IS THE PATIENT IN THIS STAGE? 2. WHAT HEALTH PATTERNS CAN BE SEEN DURING THIS STAGE? |
1. The recovery stage can take awhile, up to 2yrs.
2. During this stage the patient will show improvement in symptoms; muscle strength & function return. |
|
|
GUILLAIN-BARRE
(RECOVERY STAGE) 1. WHEN THE PATIENTS MUSCLE STRENGTH & FUNCTION RETURN WHICH DIRECTION IS IMPROVEMENT SEEN? |
1. When the patient starts to recover he sees muscle strength & function return in descending order (head to feet).
|
|
|
GUILLAIN-BARRE
1. WHAT ARE THE DIAGNOSTIC TEST AND WHAT DOES EACH REVEAL IN A PT. WITH (GB)? |
1. CSF (spinal tap); will show an increase in protein levels but the cell counts will be normal (eg.WBC)
2. EMG (will show a decrease in nerve conduction). 3. Pulmonary function test (check for respiratory issues/not all patients will have these issues). 4. ABG (respiratory) |
|
|
GUILLAIN-BARRE
1. CAN A PATIENT GET GB SYNDROME IF THEY HAD IT BEFORE? 2. WHAT PATIENTS HAVE AN INCREASED RISK OF HAVING A RECURRENCE OF GB DISEASE? |
1. Yes, patients can get (GB) a second time.
2. Women who had (GB) before and become pregnant has an increased chance of getting (GB) again in their 1st trimester. |
|
|
GUILLAIN-BARRE
TREATMENTS/SUPPORTIVE -FOR EACH PROBLEM LIST THE TREATMENT(except for *). 1.RESPIRATORY INFECTION 2.PAIN/THROMBOPHLEBITIS 3.RESPIRATOR FAILURE 4.NUTRITIONAL SUPPORT 5.*PT&OT 6*PLASMA PHERESIS |
1.Antibiotics
2.Morphine & Heparin SQ 3.Tracheostomy & MV |
|
|
GUILLAIN-BARRE
(IVIG) 1.HOW IS IT POOLED? 2.WHAT IS THE DOSE AND HOW IS IT ADMINISTERED? 3. WHAT SHOULD BE AVOIDED WHEN A PT. IS RECEIVING IVIG AND WHY? 4. WHAT IS ONE METHOD TO AVOID SOME SIDE EFFECTS OF IVIG? |
1. IVIG is pooled from thousands (which poses some risk).
2.The recommended dose is 1 to 2g/kg of body wt. a)administered via IV infusion for 2hrs for 5 days monthly or every 2mnths. 3. Pts. receiving IVIG should avoid getting vaccines for 2mnths a) The pt. should avoid getting vaccinations for 2mnths because the IVIG will prevent the vaccine from working. 4. By slowing the infusion some of the side effects will go away. |
|
|
GUILLAIN-BARRE
1. WHAT IS AN EMG? |
1. The EMG (electromyogram) and nerve conduction studies
2. EMG measures the electrical activity of muscle at rest and during contraction |
