CASE STUDY

C.B. is a single, self-supporting 58-year-old man with Guillain-Barré syndrome (GBS).

He came to see his family physician in early January with symptoms of fatigue,
myalgia, fever, and chills, which were accompanied by a hacking cough. He was
diagnosed with viral influenza. Three weeks later, he developed bilateral weakness,
numbness, and tingling of his 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. Shortly after arrival, he became totally
paralyzed and required endotracheal intubation and mechanical ventilation. He was
then admitted to the neurology critical care unit, where he spent 1 month. He
underwent a tracheotomy before being transferred to a medical floor, where he
spent several weeks. He was treated for pneumonia while hospitalized on the
medical floor. His pneumonia resolved before a transfer to a skilled care facility 2
days ago for further rehabilitation and continued ventilatory support for continued
neuromuscular respiratory paralysis associated with the GBS.

1. What is the etiology of GBS?

2. What type of individual is likely to be diagnosed with GBS?

3. What are the clinical manifestations of GBS?

4. Why does life-threatening respiratory dysfunction occur?

5. How is GBS diagnosed, and what tests would you expect to be performed?

6. Is the history of C.B.'s case typical?

7. What is the medical management for GBS?

8. What are the overall goals of nursing care for C.B. at this time?

9. You are concerned about the possibility of disuse syndrome related to C.B.'s
paralysis.
Describe an outcome of nursing care for C.B., and describe the independent nursing
interventions you would implement to meet that outcome.

11. What evaluative parameters could you use to determine whether C.B.'s
nutritional needs
were being met?

12. What interventions can you implement to decrease C.B.'s fear and anxiety?