5 Guillain-Barré syndrome (GBS) Nursing Diagnosis

Guillain-Barré syndrome (GBS)

Guillain-Barre syndrome (GBS) or also known as acute inflammatory demyelinating polyneuropathy (AIDP), acute idiopathic polyradiculoneuritis, acute idiopathic polyneuritis, French Polio, Landry ascending paralysis, and Landry Guillain Barre syndrome is an autoimmune disease that attacks the peripheral nervous system; and is usually precipitated by an acute infectious process. GBS belongs to the group of peripheral neuropathy diseases.

GBS is spread throughout the world, especially in developing countries and is the most common cause of acute paralysis. Incidence is often found in young adults and may increase in the 45-64 year age group. More often found in men than women. A rather high peak occurs in the 16-25 year age group, but may also develop in any age group. About half of victims have mild febrile illness 2-3 weeks before onset. Febrile infections are usually of respiratory or gastrointestinal origin.

Guillain-Bare Syndrome (GBS) is a clinical syndrome characterized by the acute onset of symptoms affecting the cranial nerves. The disease process includes demyelination and degeneration of the myelin sheath of peripheral and cranial nerves (Sylvia A. Price and Lorraine M. Wilson, 1995). GBS is a clinical syndrome of unknown cause involving peripheral and cranial nerves (Suzanne C. Smeltzer and Brenda G. 2002).

Priguna Sidharta (1985) defines that GBS or idiopathic types with the characteristics of the type of infection responsible cannot be determined are usually known as upper respiratory tract infections only or testinal gastrointestinal infections. Polyneuropathy manifestations begin to appear 1-3 weeks after the patient recovers from the primary disease. Examination of the cerebrospinal fluid revealed a dissociation between the number of cells and protein.

Early symptoms include: a feeling like pins and needles in the tips of the toes or hands or numbness in that part of the body. Legs feel heavy and stiff or hardened, arms feel weak and palms cannot grip tightly or turn things properly (open locks, open cans, etc.). These early symptoms can disappear within a few weeks, patients usually do not feel the need for treatment or it is difficult to explain to the team of doctors to request further treatment because the symptoms will disappear when examined.

The primary goal of treating a client with GBS is to provide maintenance of bodily system function, quickly overcoming life-threatening crises. Prevent infection and complications of immobility and provide psychological support for clients and families.

Nursing assessment of clients with GBS includes a history of disease, physical examination, diagnostic examination, and psychosocial assessment. Assessment of GBS complications includes continuous monitoring of the threat of acute life-threatening respiratory failure. Other complications include cardiac dysrhythmias, which can be seen by monitoring the ECG and observing the client for signs of deep vein thrombosis and pulmonary embolism, which often threaten immobilization and paralysis.

Possible nursing diagnoses are:

1. Ineffective breathing pattern related to rapidly progressive weakness of respiratory muscles and threat of respiratory failure
2. Risk for decreased cardiac output related to changes in heart rate, rhythm, and electrical conduction.
3. Imbalanced Nutrition: Less Than Body Requirements related to the inability to chew and swallow food.
4. Impaired physical mobility related to neuromuscular damage, decreased muscle strength, and decreased consciousness.
5. Anxiety related to illness and poor prognosis.
   

Tag : Medical-Surgical Nursing, Nursing Diagnosis