Nursing interventions for persons receiving immunosuppressive therapies for demyelinating pathology.

The client receiving immunosuppressive therapy for demyelinating disorders faces many challenges. The nurse should be involved in the constant assessment of the client for potential complications of the therapy as well as changes in the underlying disease process. Many of the nursing interventions focus on comfort and symptom management as well as providing information for the client and family to use in understanding the therapy and minimizing the effects of immunosuppression. Involving the family in client management will only strengthen the overall plan and outcomes for client care.

Impaired mobility: Guillain-Barré syndrome.

Guillain-Barré syndrome (GBS) is a complicated degenerative disorder which can be chronic or acute in nature. Its etiology is unclear although it has been associated with both cell- and humoral-mediated autoimmune mechanisms. Pathophysiologic effects of the disease include inflammation, demyelination of peripheral nerves, loss of granular bodies and degeneration of the basement membrane of the Schwann cell. This results in ascending paralysis and loss of cranial nerve function. Manifestations may be acute or chronic, and temporary or permanent, depending upon the degree of neuronal destruction. Due to the pervasive nature of GBS, nursing care is a challenge. Assessment of motor, respiratory and cardiac function is of key importance. Total care of the patient focuses on risks related to impaired mobility and ineffective airway clearance. Psychosocial care and patient education are also integral components of care.

Development of printed teaching materials for neuroscience patients.

Neuroscience nurses are challenged by the current climate of cost containment and the nursing shortage to continue to provide quality patient education. One strategy for meeting this challenge is to follow the process outlined in this overview for the development and use of printed materials.

Guillain-Barré syndrome: a case study.

This article presents a case study illustrating the usual course of Guillain-Barré syndrome. Rehabilitation nursing problems, interventions, and the outcome of a patient with Guillain-Barré syndrome are described.

An unusual nursing challenge: Guillain-Barré syndrome following cranial surgery.

An 84 year-old white female developed Guillain Barré syndrome (GBS) following a craniotomy for resection of a meningioma. GBS is a rare, idiopathic disease which presents multiple nursing challenges. To effectively care for the patient with GBS, it is necessary to be familiar with symptomatology, incidence and pathology. Using this information, nursing assessment may be performed and interventions developed and individualized as needed.

Guillain-Barré syndrome: giving the patient control.

The patient with Guillain-Barré syndrome (GBS) presents a complex clinical picture. Depending on the degree of paralysis, problems with communication can be significant. The patient's inability to express fears, needs and frustrations coupled with the lengthy recovery process makes GBS one of the most difficult diseases for nurses to manage. Nursing interventions, based on Orem's self-care theory, can ease the frustration and feelings of powerlessness a patient with GBS experiences.

Plasma exchange therapy reduces the nursing care needed in Guillain-Barré syndrome.

The authors compared the effect of plasma exchange therapy on the need for nursing care for 26 patients with acute idiopathic Guillain-Barré syndrome. The patients were randomized either to a plasma exchange (PE) or conservative treatment group. The need for nursing care and the need for specialist nursing services was assessed daily by the nurses at the Department of Neurology. At first, the average need for care was the same for the two groups of patients, but the pattern of care over time was different, with the PE group needing more care at the beginning and then very much less care, whilst the conservative group needed a more uniform amount of care over the entire stay at hospital. In the PE group the need for specialist nursing services increased markedly, and the need for nursing care decreased rapidly after the first 2 weeks to a level lower than that needed by control group patients, probably because PE increased muscle forces of patients. This study suggests that PE treatment is useful in reducing patients' needs for nursing care, especially after the first 2 weeks following the treatment.