Question

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

C.B. is a single, self-supporting 48-year-old man. Three weeks ago, he saw his family physician because of symptoms of fatigue, myalgia, fever, and chills, which were accompanied by a hacking cough. He was diagnosed with viral influenza. Today he has complaints of weakness, numbness, and tingling of both lower extremities, which rapidly progressed into his upper body. He was brought to the emergency department after his brother recognized the seriousness of his condition. The attending physician immediately suspects Guillain-Barre syndrome (GBS).

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1. What is your immediate concern for C.B. and why?
2. What assessment findings would tell you this is occurring?

Which set of arterial blood gases would be consistent with the presence of this complication

Answer 1

(a) The immediate concern for CB are:
- Breathing Difficulty:The paralysis or weekness can spread to the muscle that
controls breathing and may need a ventilator support.
- Heart annd Blood pressure problems: Blood pressure fluctuations and irregular heart
rhythms(cardiac arrhythmias) are the common side effects of Gullian -Barre Syndrome.
- Severe Pain: Most Gullian-Barre Syndrome patients experience severe nerve pain which
can be eased with medication.
- Blood Clots or Embolism: Due to immobility the client is at a high risk of developing
blood clots.This can be prevented by administering blood thinner's
or hemodilution agents and by wearing compression stockings.

(b) The main assessment findings of Gullian -Barre Syndrome are:
- Unsteady walk or the inability to walk or climb stairs.
- Pricking or tingling feeling in the fingers,toes,ankles and wrists.
- Weakness of the lower limbs that gradually spread to the upper body.
-Difficulty with facial movements(facial palsy) which includes difficulty in speaking (dyslexia)
and difficulty in chewing or swallowing(dysphagia).
-Difficulty in bowel and bladder control.
- Dyspnoea or difficulty in breathing.

(c)Arterial Blood Gas test measures the acidity (pH) and levels of oxygen
and carbon dioxide in the blood from the artery.This test is used to check
how well the lungs is able to move oxygen into the blood and remove carbon dioxide
from the blood.An ABG(Arterial Blood Gas) test measures the blood gas tension values of the
arterial partial pressure of oxygen(PaO2) and the arterial partial pressure of
carbon dioxide (PaCO2) and blood pH.In patients with respiratoery problems a high PaCO2
indicates respiratory acidosis and a low PaCO2 indicates respiratory alkalosis.