Flashcards in T3 - Probs of PNS (Josh) Deck (55)
Guillian Barre is a problem of the ---
Guillian Barre is caused by what?
demylenation of peripheral nerves which leads to disruption of sensory and motor pathways
Etiology of Guillian Barre
Immune mediated response (IgG antibodies)
Patho of Guillian Barre
T cells migrate to peripheral nerves
Macrophages break down myelin
Inflammation can cause axonal damage (mostly temporary)
What are the stages of Guillian Barre?
Initial (1-4 wks)
Plateau (several days to 2 yrs)
Recovery (4-6 mths up to 2 yrs)
S/S of Guillian Barre
Initial muscle weakness and pain
Cranial nerve dysfunction
What is the Ascending paralysis?
symmetric, bilateral, ascending motor loss
What is the Autonomic Dysfunction caused by GB?
Which cranial nerves are typically affected?
What happens to respiratory function?
changes in Tidal Volume
Treatment plan of Guililan Barre:
Intravenous Immune Globulin (IVIG)
What is Plasmapheresis?
removes circulating antibodies assumed to cause the disease
Plasma is selectively separated from whole blood
Plasma usually replaces itself or is transfused with albumin
What is the treatment regimen if the use IVIG?
daily dose based on body weight for 5 consecutive days
Nursing care for Guillian Barre.
Treat the symptoms
Monitor for complications
What are the cardio complications?
Acute Dysautonomia (HR, BP)
What are the things we need to monitor for with respiratory care?
What are the GI complications we need to monitor for?
decreased motility (paralytic ileus)
***listen to bowel sounds
***keep up with BMs
--- --- is an autoimmune disease characterized by muscle weakness.
What is Myasthenia Gravis caused by?
antibodies interfere with the transmission of ACh at the neuromuscular junction
What are the different types of Myasthenia Gravis?
What is Tensilon Testing?
baseline assessment of cranial muscle strength
**tested with Myasthenia Gravis
What is a positive Tensilon Test?
onset of muscle tone improvement within 30-60 secs after Tensilon injection
***lasts 4-5 mins
- facial fasciculations
- cardiac arrhythmias
- abdominal pain
What drug do we need to have at bedside when doing the test?
Why could you have a Cholinergic Crisis?
too much cholinisterase inhibitor drug (overmedication)
**remember that MG is a problem with too little ACh so cholinsterase inhibitors are used to treat
What are s/s of Cholinergic Crisis?
Increased Bronchial secretions
What is the treatment for Cholinergic Crisis?
Maintain resp function
Withhold anticholinergic drugs while on vent
What is a Myasthenia Crisis?
too little cholinisterase inhibitor drug (undermedication)
S/S of Myasthenia Crisis?
Flare of MG symptoms