GB

Question 1

definitions

Answer 1

acute/rapid 2-3 wks demyelinating dz of the peripheral nervous system

Question 2

what happens

Answer 2

the immune system attacks the myelin so the nerves can’t communicate. the dendrites collect signal sends down axon passes signal down myelin to the neuromuscular junction then to muscle fibers

Question 3

etiology

Answer 3

no clear, might be autoimmune

Question 4

triggered by

Answer 4

infection from campylobacter, mycoplasma pna, h influ (gram -), or viral cytomegalovirus or Epstein Barr. dt they have antigens that look like myelin

Question 5

affects which systems

Answer 5

nervous endocrine, metabolic

Question 6

age and sex?

Answer 6

all ages and men more freq

Question 7

hallmark sign

Answer 7

ascending paralysis/weakness

Question 8

S&S

Answer 8

based on nerves affected, starts low extrem and ascends
nerves convey vibrations/sensation: paraesthesia
motor nerves: muscle weak, slow refelx, cant stand
cranial nerve: dbl vision/ diff speaking (7 & 12) eyes/swallowing,
resp muscles= death
autonomic nerves: constipation, B&B incont, ortho hypotension
symmetric: rapid progressive distal muscle weakness and paresthesia, deep tendon reflex
hypesthesia
bilat facial and oropharyngeal paresis
diff swallowing
*resp paralysis: poor inspiratory drive and effect, hypoxemia 2nd to resp failure
*burning toes
weakness/paralysis will stabilize in 2 wks: will gradually improve over months to years

Question 9

diag

Answer 9

LP: increased proteins/albumin with normal wbc. normal protein 18-58 with GB protein will be in the 100’s
nerve cond/EMG: slower cond >50 normal is 20
pulmonary function test: and check abg
cbc: early leukocytosis w/ l shift

Question 10

tx

Answer 10

02, suction, cough assist, postural drainage, trach, aimed at reducing symptoms:
meds suppress the immune system
IVIG or plasmapheresis: 1st line (pick 1, combo doesn't help)
prevent thomboembolytic events
pain: gabapentin, nsaids, opioids
stress ulcer prevention
encourage intake
pt for rom
maintain skin
nutritional support

Question 11

severe polyneuropathy is a

Answer 11

medical emergency

Question 12

tx severe polyneuropathy

Answer 12

admit to icu
obtain abg and vital capacity
intubate if vc <12-15, Pa02 <70 diff clear secretions, concern for aspiration
anticipate vent support
monitor brady/tachy arrhythmia, ortho hypotension, systemic htn,