Guillain-Barré Syndrome Quiz
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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.

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    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.

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