Nursing Management for Guillain-Barre Syndrome

Guillain-Barre Syndrome is also known as Infectious Ployneuritis as well as Polyradiculitis. It characterized by paresthesias of the extremities and muscle weakness or paralysis. It is a rare disorder that the cause was thought to be of allergic or immunologic reaction. Another theory would state that it is preceded by an infection. The most common cause of this paralysis can due to the effect of polio, although polio is controlled already worldwide.

Medically known to be called as GBS, its rarity may account 2 in 100,000 people. The prognosis is good but despite that, GBS is still a life-alternating event. Many patients suffer from fast loss of control of their muscular function, vital functions may also breathing and swallowing. These symptoms can make patients feel that they are terminal. A patient with GBS will complain of sudden feeling of weakness in the legs and progresses up to the body.

Stages of GBS:

  1. Acute – the symptoms show between one to three weeks.
  2. Plateau – the symptoms show between several days to 2 weeks.
  3. Recovery – This is the stage wherein there is remyelination which may last up to 2 years.

Signs and Symptoms:

  1. Paresthesia – tingling and numbness of the lower extremities
  2. Muscle weakness of legs – progress rapidly ascending paralysis involving the trunk, upper extremities and facial muscles which may mean complete paralysis.
  3. Difficulty in chewing, swallowing and talking. The cranial nerves are now involved.
  4. Loss of sensation and sphincter disturbances of bladder and rectum.
  5. Areflexia or absence of reflexes is also observed.
  6. Respiratory failure is the respiratory muscle function is affected.

Diagnosis

The clinical manifestation is the basis of the diagnosis. The viral infection as well as motor and sensory deficits is used in determining the severity.

Nursing Management:

  1. It is important to prevent complication such as immobility as well as infection. Placing the patient in a comfortable and clean environment is a must.
  2. Plasmapheresis or exchanging plasma through a machine can also decrease the severity of GBS.
  3. For patients that have difficulty in breathing due to the involvement of respiratory muscle function, ventilator support is needed. Proper turning from time to time must be done in order to prevent accumulation of moisture on the back of the patient.
  4. Surgically, some patients must undergo tracheostomy along with mechanical ventilation.
  5. Encourage to comply with steroids such as adrenocorticotropic hormone (ACTH) and prednisone. Cytoxan or cyclophosphamide can also slow down the progress of GBS. At times, anticoagulants are given in times of thrombophlebitis.
  6. Food intake is also necessary to support the patient. A balanced diet must also be served in order to prevent tissue and muscle breakdown. Some of the patients may require gastrostomy tube in order to by support nutritionally.

 

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