Question

In: Nursing

Mr T, (33-years-old), complained of bilateral, distal hand and feet weakness that progressed to the limbs,...

Mr T, (33-years-old), complained of bilateral, distal hand and feet weakness that progressed to the limbs, trunk and respiratory muscles within a week of onset. He previously worked as an administrator. Investigations confirmed Guillain-Barré syndrome (GBS) and intravenous therapy of immunoglobins (Polygam) commenced three days ago. Upon evaluation, you find the following: • The patient requires oxygen via nasal cannula as he has 93% oxygen saturation. • Normal tone in all limbs, with reduced trunk tone and control. • Grade 3 muscle strength globally of all limbs (according to Modified Oxford scale) • Diminished sensation and proprioception throughout the body. • Able to roll independently to both sides in bed. • Requires manual and verbal cues to sit at the edge of the bed.

You decide to present Mr T as a case study to your colleagues. You are required to develop an informative PowerPoint presentation, including the following: • Pathology of GBS • Rehabilitation plan for the patient, using illustrations • Precautions observed

Solutions

Expert Solution

Guillian barre syndrome

definition

its is a neurological disorder in which body's immune system attack the peripheral nervous system.

it is a progressive auto immune disorder in which demyelination happens in the sensory and motor nerves and nerve roots

Classification

Acute inflammatory demyelinating polyneuropathy(AIDP)
Miller fisher syndrome(MFS)
Acute motor axonal neuropathy(AMAN)
Acute motor sensory axonal neuropathy(AMSAN)
Acute panautonomic neuropathy
Bickerstaff's brain stem encephalitis(BBE)

Pathology

Its an autoimmune disorder caused by bacterial or viral infection .mainly campylobacter jejuni , cytomegalovirus,epstein barr virus,and micoplasma pneumoniae

two pathophysiological forms are there

demyelination forms of GBS
Axonal forms of GBS

Compylobacter jejuni infection
Immune response to LOS
Cross reaction takes place with antibodies to nerve gangliosides
Leads to nerve dysfunction
Conduction dysfunction block
Nerve repair happens
Dymyelination takes place

cinical symptoms

Progressive muscle weakness
Pain
Loss of reflexes at lower extremities
Tingling sensation over the extremities
Tenderness
Muscle pain
Low blood pressure
Paresthesis
muscle spasm
Palpitations
Variations in heart rate
Cardiac arrhythmia
increased Sweating

diagnosis

medical history
Physical examination
tests
nerve conduction studies
Examination of csf fluid
Electromyography
Electrocardiogram
Pulmonary function tests

treatment

pain management
Supportive care
Ventilator support
Immunoglobulin therappy
Plasmapheresis

Rehabilitation

There is no specific treatment for this condition.Some of the rehabilitative traetments include

Regain patients independence with everyday tasks
Retraining can be done for the normal movements
Improve patient posture
Improve the balance and coordination
Maintain clear airway
Prevent lung infection
Support the joints to minimise damage or deformity
Pressure sore prevention
Maintain peripheral circulation

nursing management

give psychological support for the patient and family members
Spiritual support
Good assessment
Management of symptoms
Check the ECG variations continously
Assist in rehabilitation and physiotherapy
Supportive care

Precautions

there are no such precautions to prevent this disease .it takes months or years to recover.seek medical help if needed.otherwise through therapies and rehabilitation prognosis is good

Nightingale answered 1 year ago

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