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

  1. Acute inflammatory demyelinating polyneuropathy(AIDP)
  2. Miller fisher syndrome(MFS)
  3. Acute motor axonal neuropathy(AMAN)
  4. Acute motor sensory axonal neuropathy(AMSAN)
  5. Acute panautonomic neuropathy
  6. 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

  1. demyelination forms of GBS
  2. Axonal forms of GBS
  1. Compylobacter jejuni infection
  2. Immune response to LOS
  3. Cross reaction takes place with antibodies to nerve gangliosides
  4. Leads to nerve dysfunction
  5. Conduction dysfunction block
  6. Nerve repair happens
  7. 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

  1. Regain patients independence with everyday tasks
  2. Retraining can be done for the normal movements
  3. Improve patient posture
  4. Improve the balance and coordination
  5. Maintain clear airway
  6. Prevent lung infection
  7. Support the joints to minimise damage or deformity
  8. Pressure sore prevention
  9. 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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