Tanta University

Faculty of Nursing
Critical and Emergency Department

Guillain-Barré Syndrome

Prepared by:
Asala hasan
Asala mohamed
Afnan elkenz
Alaa ahmed
Alaa maray
Alaa rasmy
Alaa gaber
Alaa zaki

Under supervision: Group : 5

Dr: Sanaa Elfeky
Outlines:

➢ Defination

➢ Pathophysiology

➢ Causes

➢ Signs and symptoms

➢ Medical management

➢ Nursing management

➢ Referance
 Definition:

Guillain Barre syndrome is a rare disorder

in which body's immune system attacks
nerves and
causes damage to the peripheral nerves.
It can be treated and most people will eventually make a full recovery,
although it can occasionally be life-threatening and some people are left with
long-term problems.

Guillain-Barré syndrome affects people of all ages but it is more common in

adults and males
 Causes:
The exact cause of Guillain-Barre syndrome is unknown
Barré syndrome caused by a problem with the immune system
Infection ( bacterial , viral ,protozoan)
infection with the Zika virus, infection with the COVID-19 virus, Infection with
Campylobacter jejuni
Surgeries
Blood transfusion
Transplantation
Anesthesia
Vaccination (swine flu, AstraZeneca COVID-19 vaccine.)
Diarrhea or a respiratory illness.

Sign & symptoms:

✓ Symptoms start in feet and hands before spreading to arms and legs. These symptoms
usually affect both sides of the body at the same time.
1- numbness.
2- pins and needles.
3- muscle weakness.
4- pain problems with balance and co-ordination.
✓ Symptoms may continue to get worse over the next few days or weeks. It usually reaches
its most severe point within 4 weeks.
1- Sever pain .
2- difficulty walking without assistance.
3- an inability to move the legs, arms or face (paralysis).
4- difficulty breathing.
5- blurred or double vision.
6- difficulty speaking.
7- problems swallowing or chewing.
8- difficulty peeing, and constipation
 Medical Management:

❖ Intravenous immunoglobulin (IVIG)

is a treatment made from donated blood that contains healthy antibodies,

and given directly into a vein

❖ Plasma exchange

involves being attached to a machine that removes blood from a vein and
filters out the harmful antibodies that are attacking your nerves before
returning the blood to your body, and people need treatment over the course
of around 5 days.

❖ Corticosteroids: moderate-quality evidence suggests that corticosteroids

given alone do not significantly hasten recovery from Guillain-Barré
syndrome or affect the long-term outcome; they may even delay recovery.
❖ Deep vein thrombosis (DVT) prophylaxis: DVT due to immobility should
be prevented with gradient compression stockings and subcutaneous low
molecular weight heparin. See the separate Prevention of Venous
Thromboembolism article.
❖ Pain relief: may be required for neuropathic.

Nursing care plan:

1- Improved respiratory function.

2- Promotion of physical mobility.
3- Prevention of contractures.
4- Decreased anxiety and pain.
5- Relief of urinary retention.
6- Improvement of parental care and prevention of complications.
 1. Nursing care plan for Ineffective breathing pattern
-Assess frequency, symmetry, and depth of breathing.
-Observed for increased work of breathing and evaluate skin color,
temperature, capillary refill.
-Observe for signs of respiratory fatigue such as shortness of breath, decreased
attention span, and impaired cough.
-Auscultate lung sounds for any changes.
-Assess oxygen saturation and review client’s arterial blood gases results.
-Keep the head of bed elevated at around 35-45°.
-Perform chest physiotherapy which includes postural drainage, chest
percussion, chest vibration

-Suction secretions as appropriate, especially if the client is intubated or

undergone a tracheostomy.
1. Nursing care plan for acute pain

1- Assess level of pain and ability to engage in activities.

2- Administer analgesics based on pain assessment and respiratory status
And Monitor side effect after administration.
3- Provide support to extremities.
4- Apply a moist warm compress to painful areas as needed.
5- maintain clean, comfortable bed
6- using egg-crate mattress.
7- padding to bony prominences.
1. Nursing care plan for impaired physical mobility
1-Assess motor strength or functional level of mobility.

2- Monitor nutritional needs as they associate with immobility.

3-Place the client in a position of comfort. Provide frequent position changes

as tolerated.
4- Administer heparin as ordered. Nursing

Low- molecular-weight heparin (LMWH) is administered in the prophylaxis

of deep vein thrombosis.

5- Provide padding to bony prominences such as elbow and heels.

6-Perform active, passive and isotonic range of motion exercises as

appropriate.

7-Evaluate the need for assistive devices and provide a safe environment .

8-Provide rest periods in between activities. Consider energy-saving

techniques.

9-Assist client and their families to establish goals in participation with

activities

9- Nursing care plan for Impaired urinary elimination

1-Assess progressive degree of paralysis and effect on urinary elimination.

2-Monitor intake and output every 4 to 8 hours and palpate bladder every 2
hours; assess for cloudy, foul-smelling urine.

3-If needed, insert an indwelling urinary catheter to maintain elimination

4-Instruct to report any reduction or absence of urinary elimination.

10- Nursing care plan for anxiety

1- Assess source and level of anxiety

2-Encourage parents to stay with the child and in the care of the child.

3- Therapeutically communicate with parents and child and answer questions

in a calm and honest manner
4-Assist parents and child to recognize improvements resulting from
treatments.

5- Allow the child to participate in own care depending on ability and degree
of paralysis.

6- Teach parents and child about disease

Condition and manifestation

7. Clarify any information and answer questions in lay terms and utilize visual
aids for reinforcement if helpful

11- Nursing care plan for Altered Parenting

1-Assess for presence of permanentDisability or possibility of long-term

recovery and effect on parents.

2- Encourage parents to express feelings and unmet needs and ability to meet
and develop selfexpectations.

3-Teach about physical therapy programIncluding ROM, exercises

4-Continue to inform and support parents during the recovery period (provide
telephone numbers)
References:

https://www.slideshare.net/binuenchappanal/guillain-barre-syndrome-237363546

https://www.mayoclinic.org/diseases-conditions/guillain-barre-
syndrome/symptomscauses/syc-20362793

https://www.nhs.uk/conditions/guillain-barre-syndrome/symptoms/

https://my.clevelandclinic.org/health/diseases/15838-guillain-barre-syndrome

https://www.nature.com/articles/nrneurol.2014.121

https://nurseslabs.com/guillain-barre-syndrome-nursing-care-plans/