N213: Health Differences Across the Life Span 3

N213: Health Differences Across the Lifespan 3 Study Guide Expected outcomes for amyotrophic lateral sclerosis (ALS): • Demonstrates increased comfort level • Able to make needs known through alternate means of communication like eye blinks or finger taps • Patient and family verbalize understanding and acceptance of condition • Patient and family demonstrate adequate coping skills Guillain-Barre Syndrome Guillain-Barre is a very rare disease that is caused by the immune system destroying the myelin sheath. It usually comes on suddenly and causes acute weakness of the muscles leading to total paralysis. The cause is unknown, but the disease is known to be autoimmune in nature. It is thought to be triggered by a viral or bacterial infection, which in turn sets off a cell-mediated immune reaction in the body. The most common illnesses to trigger Guillain-Barre are Eppstein-Barr, cytomegalovirus, and upper respiratory infections. It can also be triggered by vaccinations and surgery. The illness begins with a one to four week symptomatic phase, where patients then plateau and remain ill for up to two weeks. They then enter the recovery phase. During the recovery phase, muscle strength begins to improve. Ninety-five percent of patients with this disease fully recover and death is very rare. Signs and symptoms of Guillain-Barre syndrome: • Muscle weakness • Flaccid muscles • Paresthesia • Increased protein in CSF • Facial weakness • Dysphagia • Respiratory compromise • Leukocytosis • Denervation on EMG • Decreased or absent reflexes • Blood pressure changes • Autonomic dysfunction Nursing assessment for Guillain-Barre syndrome: • Head to toe general assessment o Evaluate respiratory status: efforts to breathe, breath sounds, and 02 saturations o Check vital signs: temperature, pulse, respirations, and bloodpressure o Neurological examination: paresthesia, reflexes, muscle strength, facial muscles, and swallowing/gag reflex • Inquire about recent viral or bacterial infections • Ask about history of autoimmune disease: personal and family ©2017 Achieve Test Prep Page 98 of 204

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