Guillain-Barré Syndrome Quiz
50 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which treatment is used to reduce circulating antibodies in Guillain-Barré Syndrome?

  • Plasmapheresis (correct)
  • Physical therapy
  • Corticosteroids
  • Antibiotic therapy

    • What is a critical aspect of medical management for Guillain-Barré Syndrome?

  • Outpatient monitoring
  • Surgical intervention for nerve repair
  • Long-term rehabilitation therapy
  • Immediate respiratory support (correct)

    • Which manifestation is NOT associated with Guillain-Barré Syndrome?

  • Tachycardia
  • Paroxysms of pain in the fifth cranial nerve (correct)
  • Diminished or absent reflexes
  • Cranial nerve symptoms

    • What is a common nursing intervention for patients with Guillain-Barré Syndrome?

    <p>Enhancing physical mobility</p> Signup and view all the answers

    Which symptom is characteristic of a condition affecting the fifth cranial nerve?

    <p>Paroxysms of pain</p> Signup and view all the answers

    What is the primary focus of developing nursing diagnoses from an assessment?

    <p>Recognizing abnormal findings and risks</p> Signup and view all the answers

    Which assessment finding indicates a potential priority concern for the nurse?

    <p>Capillary refill time of 5 seconds to BUE</p> Signup and view all the answers

    When prioritizing nursing diagnoses, which method should be utilized first?

    <p>Assessing based on ABCs</p> Signup and view all the answers

    Which nursing action is considered a priority intervention for a patient exhibiting altered mental status?

    <p>Providing a calm and safe environment</p> Signup and view all the answers

    In the context of risk assessments vs. active diagnoses, what should the nurse prioritize?

    <p>Treating immediate clinical concerns</p> Signup and view all the answers

    Which vital sign finding would most require further evaluation in the context of ABC prioritization?

    <p>Oxygen saturation of 94% on room air</p> Signup and view all the answers

    What should be the nurse's immediate action for a patient who previously fell and has a GCS of 14?

    <p>Ensure patient safety and supervision</p> Signup and view all the answers

    Which nursing diagnosis might be relevant for a patient with a stage 2 pressure ulcer and a past medical history of COPD?

    <p>Risk for impaired skin integrity</p> Signup and view all the answers

    What is the normal range for intracranial pressure (ICP)?

    <p>10 – 20 mm Hg</p> Signup and view all the answers

    What does a Cerebral Perfusion Pressure (CPP) of less than 50 mm Hg indicate?

    <p>Permanent damage to the brain</p> Signup and view all the answers

    Which of the following symptoms can indicate late clinical manifestations of increased ICP?

    <p>Projectile vomiting</p> Signup and view all the answers

    What should be monitored regularly for a patient with increased intracranial pressure?

    <p>Vital signs and neurological status</p> Signup and view all the answers

    Which of the following is a potential complication of inserting an external ventricular device (EVD)?

    <p>Meningitis</p> Signup and view all the answers

    What intervention is NOT appropriate for managing a patient with increased ICP?

    <p>Encourage fluid retention</p> Signup and view all the answers

    Which of the following reflects early clinical manifestations of increased ICP?

    <p>Weakness in extremities</p> Signup and view all the answers

    Which nursing intervention would best promote bladder function in a patient experiencing urinary incontinence?

    <p>Implement a bladder training program</p> Signup and view all the answers

    What is the expected treatment for a patient diagnosed with SIADH?

    <p>Fluid restriction</p> Signup and view all the answers

    What is one of the primary goals when caring for a patient with increased intracranial pressure?

    <p>Maintain normal temperature levels</p> Signup and view all the answers

    What is the primary focus of managing intracranial pressure?

    <p>Maintain cerebral perfusion</p> Signup and view all the answers

    What positions should be avoided to reduce intracranial pressure?

    <p>Hip flexion</p> Signup and view all the answers

    Which medication is considered inappropriate for patients with congestive heart failure?

    <p>Mannitol</p> Signup and view all the answers

    What is essential for preventing infection during ICP monitoring?

    <p>Strict aseptic technique</p> Signup and view all the answers

    Which of the following is NOT a nursing intervention to optimize cerebral tissue perfusion?

    <p>Encourage patient activity</p> Signup and view all the answers

    What is a common early sign of increased intracranial pressure?

    <p>Headache</p> Signup and view all the answers

    What is the recommended position for a patient to promote venous drainage in intracranial pressure management?

    <p>Elevated head between 0 to 60 degrees</p> Signup and view all the answers

    What condition should be monitored for in patients with significant fluid loss?

    <p>Diabetes insipidus</p> Signup and view all the answers

    Which type of seizure is characterized by impaired consciousness?

    <p>Complex partial seizure</p> Signup and view all the answers

    During a seizure, which observation should the nurse record?

    <p>Aura experienced before the seizure</p> Signup and view all the answers

    What is a nursing precaution to take when caring for a patient during a seizure?

    <p>Loosen clothing and clear the area</p> Signup and view all the answers

    What characterizes a focal seizure?

    <p>Originates in one hemisphere</p> Signup and view all the answers

    What should be monitored frequently in patients at risk of complications from increased ICP?

    <p>Intake and output hourly</p> Signup and view all the answers

    What surgical procedure involves making burr holes to relieve swelling?

    <p>Burr holes procedure</p> Signup and view all the answers

    Which of the following is a common trigger for pain in trigeminal neuralgia?

    <p>Eating or brushing teeth</p> Signup and view all the answers

    What is the most common surgical treatment for trigeminal neuralgia?

    <p>Radiofrequency thermal coagulation</p> Signup and view all the answers

    What is a characteristic symptom of Bell's palsy?

    <p>Unilateral facial muscle weakness</p> Signup and view all the answers

    Which class of medications is primarily used for managing symptoms of Parkinson's Disease?

    <p>Levodopa and dopamine agonists</p> Signup and view all the answers

    What is the primary characteristic of amyotrophic lateral sclerosis (ALS)?

    <p>Progressive weakness and muscle atrophy</p> Signup and view all the answers

    Which treatment is primarily aimed at reducing inflammation in Bell's palsy?

    <p>Corticosteroid therapy</p> Signup and view all the answers

    In which demographic is trigeminal neuralgia most commonly seen?

    <p>Women in their fifth and sixth decades</p> Signup and view all the answers

    Which neuronal pathology is involved in Huntington's Disease?

    <p>Loss of cells in the striatum and cortex</p> Signup and view all the answers

    What is the recommended nursing intervention for a patient with Parkinson's Disease to prevent aspiration?

    <p>Advise staying upright during meals</p> Signup and view all the answers

    What is an expected clinical manifestation of metastatic brain tumors?

    <p>Memory loss and confusion</p> Signup and view all the answers

    Which of the following is NOT a typical treatment for spinal cord tumors?

    <p>Antiviral medication</p> Signup and view all the answers

    What is a common risk factor for developing degenerative disk disease?

    <p>Advanced age or previous trauma</p> Signup and view all the answers

    How does the treatment for cervical disk herniation primarily aim to address symptoms?

    <p>Relieving pain and improving mobility</p> Signup and view all the answers

    Study Notes

    ADPIE Review

    • ADPIE is the nursing process: Assessment, Diagnosis, Planning, Intervention, Evaluation.
    • Consider ABC's (Airway, Breathing, Circulation) when prioritizing nursing interventions.
    • Use Maslow's Hierarchy of Needs to guide your nursing care.
    • Nursing Diagnoses:
      • Risk diagnoses - potential problems.
      • Active diagnosis - current problems.

    Neurological Function

    • Normal Intracranial Pressure (ICP): 10-20 mmHg.
    • The skull is a rigid structure, so the brain cannot expand.
    • The brain compensates for increased ICP by displacing Cerebrospinal Fluid (CSF) or blood.
    • If compensation fails, ICP increases, leading to cerebral edema and brain damage.

    Cerebral Perfusion Pressure (CPP)

    • CPP: Mean Arterial Pressure (MAP) - ICP.
    • Normal CPP is 70-100 mmHg.
    • CPP below 50 mmHg results in permanent brain damage.

    Clinical Manifestations of ICP:

    • Early Signs:
      • Changes in level of consciousness (LOC).
      • Restlessness, confusion, increasing drowsiness, increased respiratory effort, purposeless movements.
      • Pupillary changes and impaired ocular movements.
      • Weakness in one extremity or one side.
      • Headache: constant, increasing, aggravated by movement or straining.
    • Late Signs:
      • Further deterioration of LOC (stupor to coma).
      • Hemiplegia, decortication, decerebration, flaccidity.
      • Respiratory alterations (Cheyne-Stokes breathing, respiratory arrest).
      • Loss of brainstem reflexes (pupil, gag, corneal, swallowing).

    Cushing's Triad:

    • Signals brainstem herniation.
    • Characteristics:
      • Hypertension: Increased systolic blood pressure.
      • Bradycardia: Decreased heart rate.
      • Irregular Respiration: Breathing pattern changes.

    ICP Monitoring:

    • External Ventricular Device (EVD): A catheter placed in the ventricle to drain CSF and monitor ICP.

    Complications of ICP Management:

    • Infection: Risk of infection due to catheter placement.
    • Brain stem herniation: Serious neurological complication.
    • Diabetes Insipidus: Excessive urine output due to decreased antidiuretic hormone (ADH) production.
    • Syndrome of Inappropriate Antidiuretic Hormone (SIADH): Excessive ADH production, leading to fluid retention and low sodium levels.

    Medical Management of ICP:

    • Goal: Maintain cerebral perfusion and reduce ICP.
    • Treatments:
      • Drainage of CSF: With EVD or lumbar puncture.
      • Decrease Cerebral Edema: Medications like Mannitol (avoid in CHF) or other osmotics.
      • Maintain Cerebral Perfusion:
        • Dobutamine: Inotropic agent to increase cardiac output.
        • Levophed: Vasopressor to increase blood pressure.
      • Control Fever: Fever increases ICP.
      • Maintain Oxygenation: Critical for brain function.
      • Reduce Metabolic Demands: Minimize activity and stimulation.

    Nursing Interventions for ICP:

    • Maintain a patent airway and breathing pattern: Monitor for respiratory distress, provide supplemental oxygen if needed.
    • Optimize cerebral tissue perfusion: Elevate head of bed (HOB) 0-60 degrees, avoid hip flexion, Valsalva maneuver, and other ICP-increasing activities.
    • Maintain negative fluid balance: Administer IV fluids slowly, monitor for dehydration and fluid overload.
    • Prevent infection: Use strict aseptic technique when managing EVD, monitor for signs of infection.
    • Monitor and manage complications (infection, brain stem herniation, diabetes insipidus, SIADH): Early detection is crucial.

    Intracranial Surgery:

    • Craniotomy: Opening the skull to access the brain.
      • Supratentorial: Incision on the forehead.
      • Infratentorial: Incision at the back of the skull.
      • Transsphenoidal: Through the nose or mouth.
    • Burr Holes: Drilling holes in the skull to relieve pressure.
    • Medical Management after Surgery:
      • Manage seizures, cerebral edema, and infection.

    Seizures:

    • Definition: Abnormal brain activity due to sudden excessive firing of neurons.
    • Types:
      • Partial: Originates in one hemisphere.
        • Simple: Consciousness remains intact.
        • Complex: Impairment of consciousness.
      • Generalized: Bilateral involvement.
      • Unknown: Epilepsy spasms.
    • Provoked: Seizures related to an acute, reversible condition.
    • Causes:
      • Cerebrovascular disease.
      • Hypoxemia.
      • Fever.
      • Head injury.
      • Hypertension.
      • Infections.
      • Metabolic and toxic conditions.
      • Brain tumor.
      • Drug and alcohol withdrawal.
      • Allergies.

    Nursing Observations During a Seizure:

    • Before the Seizure:
      • Aura: Unusual sensation preceding the seizure.
      • Focal Onset: Where the seizure begins.
      • Motor Movements: Type and area involved.
      • Pupils: Dilation, constriction, reactivity.
      • Turning of the Head: Direction and movement.
      • Automatisms: Involuntary motor activities.
      • Incontinence: Urinary or fecal incontinence.
    • During the Seizure:
      • Duration: How long the seizure lasts.
      • Loss of Consciousness: Level of consciousness.
      • Paralysis: Paralysis of limbs.
      • Speech: Slurred speech, difficulty speaking.
      • Movements: Type and distribution of movements.
    • After the Seizure:
      • Sleep: Post-ictal sleep.
      • Confusion: Cognitive impairment post-seizure.

    Seizure Precautions:

    • Protect the client:
      • Safe position: Side-lying to prevent aspiration.
      • Protect the head: Protect from injury during seizure activity.
      • Loosen clothing: Prevent restriction of breathing.
      • Clear the area: Remove objects that could cause injury.
      • Raise and pad side rails: Prevent falls.
      • Bed in lowest position: Reduce risk of falls.
      • Suction set-up: Required in case of airway obstruction.

    Guillain-Barré Syndrome:

    • An autoimmune disease affecting the peripheral nervous system, leading to muscle weakness and paralysis.
    • Clinical Manifestations:
      • Weakness and paralysis, typically starting in the lower extremities and progressing upward.
      • Bulbar weakness (affecting muscles controlling speech, swallowing, and breathing).
      • Cranial nerve symptoms.
      • Cardiovascular instability (tachycardia, bradycardia, hypertension, hypotension).
    • Management:
      • Medical Management: Plasmapheresis (removing antibodies from blood) or intravenous immunoglobulin (IVIG) to suppress the immune response.
      • Nursing Management: Maintain respiratory function (mechanical ventilation may be needed), enhance physical mobility, provide adequate nutrition, improve communication, decrease fear and anxiety, monitor and manage complications.
      • Recovery: Gradual recovery with physical and occupational therapy.

    Trigeminal Neuralgia:

    • Also known as "tic douloureux".
    • Characterized by excruciating pain episodes in the face, usually affecting the second and third branches of the trigeminal nerve.
    • Treatment:
      • Medications: Antineuralgics, anticonvulsants.
      • Surgery: To interrupt pain signals.

    Spinal Cord Injuries:

    • Complete: Total loss of sensation and motor function below the level of the injury.
    • Incomplete: Some function remains below the level of injury.
    • Levels of Injury:
      • Cervical: Affects arms, hands, and legs.
      • Thoracic: Affects the chest, abdomen, and legs.
      • Lumbar: Affects the legs, feet, and bowel and bladder control.
      • Sacral: Affects the bowels and bladder.
    • Complications:
      • Spinal shock: Temporary loss of reflexes below the level of the injury.
      • Autonomic dysreflexia: Dangerous condition characterized by sudden, uncontrolled rise in blood pressure.
    • Management:
      • Medical Management: Stabilize the spine, prevent further injury, manage pain and spasms, prevent complications.
      • Nursing Management: Maintain spinal alignment, prevent pressure ulcers, promote bowel and bladder control, provide emotional support.

    Stroke:

    • Definition: A brain injury caused by a disruption of blood flow to a specific portion of the brain.
    • Types:
      • Ischemic: Caused by a blockage of a blood vessel.
      • Hemorrhagic: Caused by a ruptured blood vessel.
    • Clinical Manifestations:
      • Sudden onset of neurological deficits: Weakness/paralysis, numbness/tingling, speech difficulties, vision changes, altered mental status, headache.
      • Symptoms vary depending on the affected area of the brain: Left brain stroke (right side paralysis), right brain stroke (left side paralysis).
    • Management:
      • Medical Management: Focuses on restoring blood flow to the brain, preventing further damage, and managing complications.
      • Nursing Management: Maintain airway and breathing, monitor vital signs, protect from injury, promote communication, provide emotional support.
      • Rehabilitation: Physical, occupational, and speech therapy to optimize function.

    Meningitis:

    • Definition: Inflammation of the meninges (membranes surrounding the brain and spinal cord).
    • Causes: Bacterial, viral, or fungal infections.
    • Clinical Manifestations:
      • Fever, headache, stiff neck, photophobia (sensitivity to light), nausea, vomiting, altered mental status, rash (in some cases).
    • Management:
      • Medical Management: Antibiotics for bacterial meningitis, antiviral medications for viral meningitis.
      • Nursing Management: Monitor vital signs, assess neurological status, administer medications, prevent complications (seizures, increased ICP), provide comfort measures.

    Multiple Sclerosis (MS):

    • Definition: Autoimmune disease that attacks the myelin sheath (protective covering of nerve fibers) in the brain and spinal cord.
    • Clinical Manifestations: Widely variable, including:
      • Fatigue.
      • Weakness.
      • Numbness/tingling.
      • Dizziness.
      • Impaired vision.
      • Bowel and bladder dysfunction.
      • Cognitive impairment.
    • Management:
      • Medical Management: No cure, focus on symptom management and slowing disease progression.
      • Nursing Management: Provide education about the disease, manage symptoms, promote independence, optimize quality of life, provide emotional support.

    Parkinson's Disease:

    • Definition: Neurodegenerative disorder that affects movement, resulting from loss of dopamine-producing cells in the brain.
    • Clinical Manifestations:
      • Tremors: Involuntary, rhythmic shaking of the hands, legs, or head.
      • Rigidity: Stiffness and resistance to movement in the muscles.
      • Bradykinesia: Slowness or absence of movement.
      • Postural instability: Difficulty maintaining balance.
    • Management:
      • Medical Management: Medications to increase dopamine levels or block the effects of acetylcholine.
      • Nursing Management: Assist with activities of daily living, promote safety, promote mobility, provide education about the disease, provide emotional support.

    Alzheimer's Disease:

    • Definition: A progressive neurodegenerative disease that causes dementia, characterized by deterioration of brain cells.
    • Clinical Manifestations:
      • Memory loss.
      • Confusion.
      • Difficulty with language.
      • Impaired judgement.
      • Behavioral changes.
      • Personality changes.
    • Management:
      • Medical Management: No cure, focus on symptom management and slowing disease progression.
      • Nursing Management: Provide a safe environment, manage behavioral changes, maintain cognitive function, provide emotional support for the patient and family.

    Traumatic Brain Injury (TBI):

    • Definition: Injury to the brain caused by an external force, such as a blow to the head, a penetrating injury, or a sudden movement of the head.
    • Severity: Ranges from mild concussion to severe, life-threatening injury.
    • Clinical Manifestations:
      • Headache.
      • Dizziness.
      • Nausea and vomiting.
      • Blurred vision.
      • Confusion.
      • Memory loss.
      • Loss of consciousness (in more severe cases).
    • Management:
      • Medical Management: Depends on severity of injury, may include surgery, medications for managing ICP, seizures, and pain.
      • Nursing Management: Monitor vital signs, assess neurological status, maintain airway and breathing, prevent ICP, provide support and education for the patient and family.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Week 1 Lecture - C. 34 Medical & Surgical Nursing PDF

    Description

    Test your knowledge on Guillain-Barré Syndrome with this quiz. Explore its symptoms, critical aspects of medical management, treatments, and common nursing interventions. Challenge your understanding of this neurological condition.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser