Askep pasien yang mengalami
Guillain-Barré Syndrome
Maridi M. Dirdjo
Pendahuluan
• Guillain-Barré syndrome is one of the most common
peripheral nervous system disorders, affecting about
3500 people in the United States and Canada each
year (Porth, 2005).
• The cause isunknown, but precipitating events
include a respiratory or gastrointestinal viral or
bacterial infection 1 to 3 weeks prior to the onset of
manifestations, surgery, viral immunizations, and
other viral illnesses.
• In 60% of cases,Campylobacter jejuniis identified as
the cause of the preceding infection.
• Approximately 80% to 90% of clients with GBS have
a spontaneous recovery with little or no residual
disabilities.
pengertian
• Guillain-Barré syndrome (GBS) is also called
acute inflammatory polyneuropathy, acute
inflammatory demyelinating
polyradiculoneuropathy, acute axonal motor
neuropathy, and acute motor and sensory axonal
neuropathy
• GBS is an inflammatory disorder characterized
by abrupt onset of symmetrical paresis
(weakness) that progresses to paralysis.
Pengertian
• Guillain-Barré syndrome (GBS)is an acute
inflammatory demyelinating disorder of the
peripheral nervous system characterized by an
acute onset of motor paralysis (usually
ascending).
• Guillain-Barré syndrome (GBS) is an acute
inflammatory process involving the motor and
sensory neurons of the peripheral nervous
system.
Etiologi
• GBS is believed to be caused by an autoimmune
response to some type of viral infection or to
certain vaccines, although the exact cause is not
known.
• Usually the viral illness affects the respiratory or
gastrointestinal system, and occurs within 2
weeks prior to onset of neurologic symptoms.
• Average age at onset is 30 to 50; men and
women are equally affected
Patogenesis
• The disease is characterized by progressive
ascending flaccid paralysis, accompanied by
paresthesias and numbness.
• About 20% of clients have respiratory
involvement to the point that ventilatory
assistance is required. GBS is often a medical
emergency.
PaTOfisiologi
• The primary pathophysiologic process in GBS is the
destruction of myelin sheaths covering the axons of
peripheral nerves.
• The demyelination is thought to be the result of both
a humoraland cell-mediated immunologic response.
• The loss of myelin results in poor conduction of
nerve impulses, causing sudden muscle weakness
and loss of reflex response.
• Other manifestations occur when nerve conduction
to various muscles is interrupted.
• The stages of Guillain-Barré syndrome and their
usual manifestations are presented in
Diagnosis
• Diagnosis is made based on manifestations,
history of a recent viral infection, elevated CSF
protein levels, and EMG studies reflecting
decreased nerve conduction.
Medical management: obAT
• No medications are available for the specific treatment of
Guillain-Barré syndrome.
• Other medications may be prescribed to provide support
or prophylaxis, or to combat concurrent problems; for
example, antibiotics may be prescribed for urinary tract
or respiratory infections.
• Morphine is commonly administered to control muscle
pain.
• Anticoagulation therapy is usually instituted to prevent
thromboembolic complications, such as deep venous
thrombosis and pulmonary embolism, which are
associated with prolonged bed rest.
• If hypotension is a problem, vasopressors are prescribed
Pembedahan
• Tracheostomy is performed if respiratory failure
occurs.
• Clients who need ventilatory support are usually
able to be weaned after 2 to 3 weeks, but the
time frame varies greatly.
• When the client’s vital capacity reaches 8 to 10
mL/kg, he or she may be weaned from the
ventilator (Hickey, 2003).
• Insertion of a temporary pacemaker may be
indicated for bradycardia.
Plasmaferesis
• Plasma exchange has been beneficial,
particularly when performed within the first 2
weeks of the syndrome’s development.
• Antibodies are removed, and
immunosuppressive agents are administered
concurrently.
• Clients typically have five exchanges during an
8- to 10-day period
Diagnosis keperawatan
• Ineffective Breathing Pattern related to loss of
respiratory muscle function
• Impaired Physical Mobility related to
progressive loss of motor function
• Dressing/Grooming Self Care Deficit related to
decreased motor function
• Imbalanced nutrition, less than body
requirements, related to inability to swallow
• Impaired verbal communication related to
cranial nerve dysfunction
• Fear and anxiety related to loss of control and
paralysis
