Guillain-Barré Syndrome Study Guide
Exam And Actual Answers.
In what stage of Guillain-Barré syndrome does remyelination and axonal regeneration begin?
A. Sub-acute stage
B. Acute stage
C. Plateau stage
D. Recovery stage - Answer D. The first stage is known as the acute stage and starts with the onset of
signs and symptoms of peripheral nerve demyelination (destruction of myelin sheath), edema, and
inflammation. This phase lasts approximately 4 weeks. When demyelination ceases, the patient enters
the plateau stage, which lasts from a few days to weeks. In the recovery stage, remyelination and axonal
regeneration begins and there is gradual improvement in the patient's signs and symptoms.
Which findings are consistent with lumbar puncture results in a patient who has Guillain-Barré
syndrome? Select all that apply.
A. Elevated protein levels
B. Normal cell count
C. Moderate bacterial count
D. Bloody tap
E. Hypocellular - Answer A. B. Cerebrospinal fluid findings include elevated protein and normal cell
count. Electromyography results reveal slowed nerve conduction velocity soon after the patient develops
paralysis.
Use of IVIG therapy for the treatment of Guillain-Barré is based on the fact that it is thought to have
what effect?
A. Shorten recovery time by up to 75% because it blocks macrophage receptor activity
B. Be effective for long-term treatment protocols for patients who have long-term disability
, C. Help to promote antibody production
D. Inhibit complement binding - Answer D. This treatment may work by several mechanisms, which
include blocking of macrophage receptors, the inhibition of antibody production, the inhibition of
complement binding, and the neutralization of pathologic antibodies. The dosing is 2 g/kg intravenously
over 5 days.
Using plasmapheresis as a treatment option for Guillain-Barré is beneficial for what reason?
A. It can be done on an outpatient basis, thereby reducing the need for hospitalization.
B. It diminishes hospitalization length and can prevent the patient from needing mechanical ventilation if
implemented in the first week of symptom presentation.
C. It is cost effective because it doesn't require skilled nursing staff for administration.
D. It is not associated with any complications as it is not an invasive procedure. - Answer B.
Plasmapheresis is also recommended for ambulatory patients who start treatment within 2 weeks of the
onset of neuropathic symptoms. This therapy can reduce recovery time, yet requires the insertion of a
plasmapheresis catheter, skilled nursing staff, and specialized equipment that may not be available at all
medical centers. Plasmapheresis diminishes the length of hospitalization and the need for mechanical
ventilation if initiated within the first week of symptoms. There is an increased risk of infection and
hemorrhage as a result of the removal of immunoglobulins and clotting factors. Adverse reactions the
patient may experience include hypotension, bradycardia, fever, chills, and rash. Additional
complications from this treatment include septicemia, pneumonia, cardiac arrhythmias, malaise,
bleeding/clotting abnormalities, and hypocalcemia.
The nurse is performing a respiratory assessment on a patient with Guillain-Barré syndrome. What
critical assessments should the nurse perform? Select all that apply.
A. Respiratory assessment with vital capacity measurement
B. Tactile fremitus
C. Pain assessment
D. Diaphragmatic excursion
E. Motor sensory assessment - Answer A, D
For each option, select the correct assessment or test result for a patient who has been diagnosed with
Guillain-Barré syndrome (GB) and is exhibiting clinical symptoms of paralysis.
Exam And Actual Answers.
In what stage of Guillain-Barré syndrome does remyelination and axonal regeneration begin?
A. Sub-acute stage
B. Acute stage
C. Plateau stage
D. Recovery stage - Answer D. The first stage is known as the acute stage and starts with the onset of
signs and symptoms of peripheral nerve demyelination (destruction of myelin sheath), edema, and
inflammation. This phase lasts approximately 4 weeks. When demyelination ceases, the patient enters
the plateau stage, which lasts from a few days to weeks. In the recovery stage, remyelination and axonal
regeneration begins and there is gradual improvement in the patient's signs and symptoms.
Which findings are consistent with lumbar puncture results in a patient who has Guillain-Barré
syndrome? Select all that apply.
A. Elevated protein levels
B. Normal cell count
C. Moderate bacterial count
D. Bloody tap
E. Hypocellular - Answer A. B. Cerebrospinal fluid findings include elevated protein and normal cell
count. Electromyography results reveal slowed nerve conduction velocity soon after the patient develops
paralysis.
Use of IVIG therapy for the treatment of Guillain-Barré is based on the fact that it is thought to have
what effect?
A. Shorten recovery time by up to 75% because it blocks macrophage receptor activity
B. Be effective for long-term treatment protocols for patients who have long-term disability
, C. Help to promote antibody production
D. Inhibit complement binding - Answer D. This treatment may work by several mechanisms, which
include blocking of macrophage receptors, the inhibition of antibody production, the inhibition of
complement binding, and the neutralization of pathologic antibodies. The dosing is 2 g/kg intravenously
over 5 days.
Using plasmapheresis as a treatment option for Guillain-Barré is beneficial for what reason?
A. It can be done on an outpatient basis, thereby reducing the need for hospitalization.
B. It diminishes hospitalization length and can prevent the patient from needing mechanical ventilation if
implemented in the first week of symptom presentation.
C. It is cost effective because it doesn't require skilled nursing staff for administration.
D. It is not associated with any complications as it is not an invasive procedure. - Answer B.
Plasmapheresis is also recommended for ambulatory patients who start treatment within 2 weeks of the
onset of neuropathic symptoms. This therapy can reduce recovery time, yet requires the insertion of a
plasmapheresis catheter, skilled nursing staff, and specialized equipment that may not be available at all
medical centers. Plasmapheresis diminishes the length of hospitalization and the need for mechanical
ventilation if initiated within the first week of symptoms. There is an increased risk of infection and
hemorrhage as a result of the removal of immunoglobulins and clotting factors. Adverse reactions the
patient may experience include hypotension, bradycardia, fever, chills, and rash. Additional
complications from this treatment include septicemia, pneumonia, cardiac arrhythmias, malaise,
bleeding/clotting abnormalities, and hypocalcemia.
The nurse is performing a respiratory assessment on a patient with Guillain-Barré syndrome. What
critical assessments should the nurse perform? Select all that apply.
A. Respiratory assessment with vital capacity measurement
B. Tactile fremitus
C. Pain assessment
D. Diaphragmatic excursion
E. Motor sensory assessment - Answer A, D
For each option, select the correct assessment or test result for a patient who has been diagnosed with
Guillain-Barré syndrome (GB) and is exhibiting clinical symptoms of paralysis.
