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gullain-barre synd.
pn 141 test 3 book burke: pg 958
Question | Answer |
---|---|
what is it | an acute, progressive inflammation of the perihperal nervous system |
cause | unknown |
what does disease usually follow | a recent respiratory infection or GI infection, virla vaccine, or surgery |
what organism causes 60% of GB | campylobactor jejuni |
a cell mediated immune system reaction detroys the myelin sheath covering where | the peripheral nerve |
what happens without the myelin | impulses are poorly conducted to the sensory and motor nerves |
since the impulses are poorly conducted, what does this cause | rapid muscle weakness, loss of reflexes and paralysis |
s/s : where in the body do they normally start; where do they move | in the lower extremities; they move upward |
s/s: first one | bilateral numbness and tingling in the legs |
s/s :what happens w/in 24-72 hours | weakness extends to the arms and respiratory muscles, and then progresses to paralysis |
s/s: cranial nerve involvement causes prblems with what | chewing, swallowing, and talking |
s/s: what occurs if the ANS is effected | BP and PR change |
it pt alert and oriented throughout the process | yes |
what is the most serios complication | respiratory failure |
if respiratory failure occurs what is placed | trach and mechanical ventilation |
what complications are r/t the amount of time the pt is paralyzed | skin breakdown, and DVT |
how is recovery | good, with few or no residual effects |
what does recovery time depend on | how fast the myelin sheath can rebuild itself |
what is the average rehab | 6 months- 1 yr |
as nerves recover what happens to s/s | they improve in reverse order |
what is Dx based on | s/s and a recent viral infection |
Dx: what will a lumbar puncture show | elevated CSF protein levels |
Dx: what will an EMG show | slowing of nerve conduction |
tx: what is it | plasmapheresis and IV immune globulin |
plasmapheresis: what does it do | it removes the antibodies that caused the GB |
plasmapheresis: it is most benificial if used when | with in the 1st two weeks |
plasmapheresis: how many exchagnes do they have | 5 of them over 8-10 days |
what is the action of IV immunoglobulin | unclear |
IV immunoglobulin- the effects are simliar to what | plasmapheresis |
meds: why are anticoagulants given | to prevent DVT and pulmonary embolism |