guillain barre syndrome class room teaching 1st year MSc nursing

3. INTRODUCTION:
Guillain-Barré syndrome is a rare
disorder in which your body's
immune system attacks your
nerves. Weakness and tingling in
your extremities are usually the
first symptoms. These sensations
can quickly spread, eventually
paralyzing your whole body

5. What is Guillain-Barré Syndrome?
Peripheral nerves send motor and sensory
signals to and from the CNS (spinal cord and
brain). They are covered in myelin sheath,
comprised of cells called Schwann cells which
promote better conduction of signals.
Guillain-Barré causes the demyelination of
the Schwann cells, which causes damage to
the peripheral nerves and affects the way
signals are sent. As a result, Guillain-Barré can
cause weakness, tingling, changes in sensations
and paralysis in individuals affected.

6. DEFINITION:
Guillain-Barré syndrome is
a rare but serious
autoimmune disorder in
which the immune system
attacks healthy nerve cells in
your peripheral nervous
system (PNS).

7. TYPES:
Acute inflammatory demyelinating
polyradiculoneuropathy (AIDP),
● The most common form in the U.S.
● Auto immune response against
schwann cell.
● The most common sign of AIDP is
muscle weakness that starts in the
lower part of your body and spreads
upward.

8. Miller Fisher syndrome (MFS)
● Rare variant
● Manifest as a descending
paralysis.
● Usually affects the eye muscles
first and presents with the triad
of ophthalmoplegia, ataxia, and
areflexia.

9. Acute motor axonal neuropathy (AMAN)
Also known as Chinese paralytic
syndrome,
Attacks motor nodes of Ranvier and is
prevalent in China and Mexico.
Acute motor-sensory axonal
neuropathy (AMSAN)
Similar to AMAN
Affect the sensory with several axonal
damage.

10. Acute Panautonomic Neuropathy
Is the most rare variant of GBS, sometimes
accompanied by encephalopathy.
Frequently occurring symptoms include
impaired sweating, lack of tear formation,
photophobia, dryness of nasal and oral
mucosa, itching and peeling of skin, nausea,
dysphagia, and constipation unrelieved by
laxatives or alternating with diarrhea.

11. PREVALENCE OF GUILLAIN-BARRÉ SYNDROME
In Canada, an estimated 1-2.3 per 100,000 people
are affected by Guillain-Barré syndrome yearly.
Guillain-Barré can affect anyone at any age but
there is an increase in risk with age. Cases are
estimated to be 1.0-1.5 per 100,000 in individuals
15 years of age or younger. Those figures rise to 8.6
cases per 100,000 in individuals 70-79 years of
age.2 Also, cases are more prevalent in males with
1.5 males diagnosed for every female.--By Propel
Physiotherapy|August 17th, 2020

12. RISK FACTORS
● Most commonly, infection with campylobacter, a
type of bacteria often found in undercooked poultry
● Influenza virus
● Hepatitis A, B, C and E
● HIV, the virus that causes AIDS
● Mycoplasma pneumonia
● Surgery
● Hodgkin's lymphoma
● Rarely, influenza vaccinations or childhood
vaccinations

14. SIGNS AND SYMPTOMS:
❏ Prickling, pins and needles sensations in the fingers, toes, ankles
or wrists
❏ Unsteady walking or inability to walk or climb stairs
❏ Difficulty with eye or facial movements, including speaking,
chewing or swallowing
❏ Severe pain that may feel achy or cramplike and may be worse at
night
❏ Difficulty with bladder control or bowel function
❏ Rapid heart rate
❏ Low or high blood pressure
❏ Difficulty breathing

15. DIAGNOSIS:
Spinal tap (lumbar puncture): A small amount of
fluid is withdrawn from the spinal canal in your lower
back. The fluid is tested for a type of change that
commonly occurs in people who have GBS
Electromyography:Thin-needle electrodes are
inserted into the muscles your doctor wants to study.
The electrodes measure nerve activity in the muscles.
Nerve conduction studies:Electrodes are taped to
the skin above your nerves. A small shock is passed
through the nerve to measure the speed of nerve
signals

16. COMPLICATIONS:
● Breathing difficulties
● completely or have only minor, residual weakness,
numbness or tingling.
● Heart and blood pressure problems.
● Pain.
● Bowel and bladder function problems.
● Blood clots.
● Pressure sores.
● Relapse.

17. MEDICAL TREATMENT
● Plasmapheresis
● High dose immunoglobulin therapy
● Mechanical ventilator
● Pain control
● Supportive care

18. PROGNOSIS
Start after the 4th week from the onset.
Approximately 80% of patient have a complete
recovery.

19. NURSING MANAGEMENT

20. Nursing Diagnosis
❏ Impaired respiratory function related to
rapid and progressive weakness and
impending respiratory failure
❏ Immobility related to paralysis
❏ Nutritional imbalance related to swallowing
difficulties
❏ Impairments to verbal communication
related to cranial nerve dysfunction
❏ Pain
❏ Psychological problems

21. Health Teaching and Health Promotion
GBS should focus on rehabilitation efforts by the members of continuing care
interprofessional teams. Team members educate both the patient and family
members on the acute rehabilitation, long-term care, outpatient or home settings
with an emphasis on specific activities such as physical therapy, occupational
therapy, speech therapy, and nutritional therapy.
Education for family members caring for the recovering GBS patient should also
include training in the use of adaptive devices such as canes, walkers, wheelchairs,
bedside commodes, bathtub or shower benches, and safety measures such as ramps
for easy home access.
Health education about routine health maintenance screenings such as
mammograms and screening for colorectal cancer and skin cancer should be
provided to both patients and family members.

22. Evidence-Based Issues
1. limitations of evidence to identify and describe possible causal
relationships of GBS to infections and immunizations
2. lack of definitive evidence in support of either IVIG or
plasmapheresis as effective treatments for GBS.
Other issues
The nurse serves an important and sometimes overlooked role
in the management of the patient with GBS. It is also important
tO note the relevance of an interprofessional team in care
delivery to manage the complex issues connected to GBS.

23. SUMMARY
❏ DEFINE GBS
❏ TYPES OF GBS
❏ Identify potential causes and risk factors of GBS
Explain the medical management of GBS
❏ Identify key components of nursing management
and monitoring of GBS

24. JOURNAL VIEW

25. ASSIGNMENT