Guillain-Barré Syndrome: Nursing Interventions

by Rhonda Lawes, PhD, RN

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    00:01 Now, complications in Guillain-Barré can affect several parts of the body.

    00:04 We've kinda touched on it, but I wanna go a little deeper here.

    00:07 Because as a caregiver, I have to use several methods to help prevent or treat complications from this disease.

    00:16 So, you want to be on your A game with this patient.

    00:20 The biggest factor we're gonna worry about is immobility.

    00:24 Since the complications of Guillain-Barré affect several parts of the body, we're gonna have to really work on not risking skin breakdown and not risking the muscles becoming contractured and stiff, and the joints becoming problematic and stiff.

    00:39 So, one of the easiest, most simple of ways would be passive and active range of motion.

    00:45 Okay. How can you do both passive and active? Well that's progressive.

    00:50 You want the patient to stay as independent as possible, right? That's what we're looking for.

    00:57 So the movement they do have, I want to encourage them to continue to move those muscles.

    01:03 Muscles that are completely paralyzed, then I'm gonna do active range of motion with that patient.

    01:09 Now, this is usually a collaborative effort.

    01:11 Nurses and therapists will work together to do passive and active range of motion.

    01:17 We wanna keep those muscles flexible and prevent them from becoming contractured or shortened and extra stiff.

    01:23 So in order to help them in recovery, we know immediately when that patient starts having to be less mobile than normal, less active than normal, we wanna respond early and make sure we keep those joints and muscles moving so that the recovery is not as difficult.

    01:40 Now, another problem with immobility is clots.

    01:44 So we have to be on guard for thrombosis prevention.

    01:47 Now, there's a couple of things that we can do.

    01:50 The active and passive range of motion will be helpful.

    01:53 You wanna give anticoagulant medications because they're really at risk for DVT.

    01:58 That stands for deep vein thrombosis.

    02:01 Any patient that's immobile and in bed, normally when we're walking you're using those muscles and those calf muscles.

    02:09 And when those muscles are contracting and squeezing, they're pushing blood out.

    02:13 And then when they're relaxing, blood's coming back in.

    02:15 So you're constantly moving blood in and out of the body.

    02:18 But people that sit for long periods of time like on a long plane flight or people that are in bed and can't get out of bed, they're at high risk to develop a clot.

    02:29 Because as blood kind of get stagnated down there, gets real sludgy.

    02:33 And whenever blood kind of pools and hangs out, you have not as good blood flow, it's not being flushed in and out, you have a real risk for a clot or a deep vein thrombosis to develop.

    02:45 It's not good in your leg.

    02:47 And if that clot breaks off and travels to the rest of the body, it's really not a good idea.

    02:53 So, things we're gonna do for a patient is, we'll probably have them on anticoagulant medications because we wanna prevent a DVT.

    03:00 And we'll also work at pneumatic compression stockings.

    03:04 Now, that sounds super fancy.

    03:07 But really what that is that our - it looks like a stocking that you put on a patient. It has a hose connected to it that usually one patient use.

    03:16 They're made of the same material as a disposable blood pressure cuff.

    03:20 You put it on like a stocking and it will blow up, compress the leg, and then it will deflate.

    03:25 Just like you're putting a blood pressure cuff on their entire lower leg that's what pneumatic compression stockings do.

    03:34 By trying to mimic the experience of a patient who's up and walking and actually using those muscles.

    03:40 So Guillain-Barré, we know the worst case scenario is respiratory, but we also have to be on guard to prevent clots from forming.

    03:48 So we'll be on anticoagulants or antiplatelet type of medication, might have pneumatic compression stockings on.

    03:54 Remember, watch their skin like a hawk.

    03:58 You wanna be on top of that.

    04:00 Anyone who's immobile would probably benefit from some type of therapeutic bed. Right? An air mattress that helps with those pressures, and we need to be helping them turn a minimum of every two hours.

    About the Lecture

    The lecture Guillain-Barré Syndrome: Nursing Interventions by Rhonda Lawes, PhD, RN is from the course Spinal Cord Injuries and Syndromes (Nursing) .

    Included Quiz Questions

    1. Performing passive and active range of motion
    2. Using transfer lifts on every client
    3. Completing as many task for the client as possible
    4. Keeping the client on strict bed rest
    1. Administer medications to prevent DVTs.
    2. Use pneumatic compression stockings.
    3. Encourage ambulation and range of motion when appropriate.
    4. Provide foods rich in vitamin K.
    5. Promote decreased fluid intake.

    Author of lecture Guillain-Barré Syndrome: Nursing Interventions

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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