NCLEX RN Quiz # 1017

NCLEX Examination.

Practice Question # 1017.

Guillain-Barré syndrome is an autoimmune attack of the peripheral nerve myelin. The result is acute, rapid segmental demyelination of peripheral nerves and some cranial nerves, producing ascending weakness with dyskinesia (inability to execute voluntary movements), hyporeflexia, and paresthesias (numbness). In 66% of cases, there is a predisposing event, most often a respiratory or gastrointestinal infection, although vaccination, pregnancy, and surgery have also been identified as antecedent events.

The antecedent event usually occurs 2 weeks before symptoms begin. Weakness usually begins in the legs and progresses upward for about 1 month. Maximum weakness varies but usually includes neuromuscular respiratory failure and bulbar weakness.

The duration of the symptoms is variable: complete functional recovery may take up to 2 years (Hickey, 2003). Any residual symptoms are permanent and reflect axonal damage from demyelination. The annual incidence of Guillain-Barré is 0.6 to 1.9 cases per 100,000. Eighty-five percent of patients recover with minimal residual symptoms. Severe residual deficits occur in up to 10% of patients. Residual deficits are most likely in patients with rapid disease progression, those who require mechanical ventilation, or those 60 years of age or older. Death occurs in 3% to 8% of cases, resulting from respiratory failure, autonomic dysfunction, sepsis, or pulmonary emboli.