A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?

Degeneration of nerves in the brainstem and spinal cord.

Pleural effusion caused by immobility.

Demyelination of nerves that stimulate the respiratory muscles.

Bronchoconstriction and edema of the airways.

Answer and Explanation

The Correct Answer is C

A.   While GBS primarily affects peripheral nerves (nerves outside the brain and spinal cord), it does not typically cause direct degeneration of nerves in the brainstem and spinal cord. Therefore, this option is not correct in the context of respiratory distress in GBS.
B.   Pleural effusion caused by immobility: Pleural effusion, an accumulation of fluid in the pleural cavity around the lungs, is not a typical complication of GBS. It is more commonly associated with conditions such as heart failure, pneumonia, or malignancy, rather than directly with GBS.
C.   In Guillain-Barre Syndrome, demyelination of nerves affects the transmission of signals from the brain to the muscles, including those responsible for respiration. As a result, respiratory muscles may become weak or paralyzed, leading to shallow breathing and respiratory distress.
D.   While respiratory distress can occur in some neurological conditions due to autonomic dysfunction or secondary complications, such as aspiration pneumonia, bronchoconstriction and airway edema are not typical manifestations of GBS itself.

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Correct Answer is A

Explanation

A. Plasmapheresis, also known as plasma exchange, is a treatment where blood plasma containing harmful antibodies is removed from the blood and replaced with donor plasma or albumin. This procedure is effective in reducing the severity and duration of symptoms in GBS by removing the antibodies that attack the peripheral nerves. Plasmapheresis is typically recommended within the first 2 weeks of symptom onset to maximize its benefits.
B. Riluzole is a medication that modulates glutamate neurotransmission and is primarily used in the treatment of amyotrophic lateral sclerosis (ALS). While some studies have explored its potential use in GBS, its efficacy in GBS treatment remains uncertain and it is not considered a standard treatment.
C. Anticholinesterase agents, such as pyridostigmine, are used in conditions characterized by neuromuscular junction dysfunction, such as myasthenia gravis. However, in GBS, where the primary pathology is the demyelination of peripheral nerves rather than neuromuscular junction dysfunction, anticholinesterase agents are not effective and can potentially worsen symptoms.
D. Acyclovir is an antiviral medication primarily used to treat infections caused by herpesviruses, including herpes simplex virus (HSV) and varicella-zoster virus (VZV). It has no role in the treatment of GBS because GBS is not caused by viral infections.

A. It suppresses the virus which is responsible for causing the inflammation of the nerve. B. It prevents the breakdown of acetylcholine to increase the amount available at the neuromuscular junction. C. It reduces inflammation in the CNS to prevent further demyelination of nerves in the central nervous system. D. It slows the progression of the disease by decreasing the release of glutamate in the brain.

Correct Answer is D

Explanation

A. ALS is not caused by a virus or inflammation of the nerves. It is a progressive neurodegenerative disease affecting the motor neurons in the brain and spinal cord.
B. While acetylcholine breakdown is involved in other neurological conditions (such as myasthenia gravis), ALS primarily affects motor neurons and does not directly involve acetylcholine metabolism at the neuromuscular junction.
C. ALS does not typically involve significant inflammation or demyelination (which is more characteristic of conditions like multiple sclerosis). Therefore, reducing CNS inflammation is not a therapeutic target in ALS.
D. Riluzole, the medication prescribed for ALS, works by decreasing the release of glutamate, which is a neurotransmitter that can be toxic to nerve cells in high amounts. In ALS, excessive glutamate release is believed to contribute to motor neuron degeneration. By reducing glutamate release, riluzole may help protect motor neurons and slow the progression of the disease.

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A nurse is assessing a client who has Guillain-Barre Syndrome, and notes that the client's breathing is shallow and the client is short of breath. The nurse understands that that the client's respiratory distress is caused by which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client on a medical-surgical unit has been diagnosed with Guillain-Barre Syndrome. The nurse understands that in addition to supportive care, which treatment can be used within the first 2 weeks of symptom onset?

Correct Answer is A

Explanation

A nurse is caring for a client who has a new diagnosis of amyotrophic lateral sclerosis (ALS), and a new prescription for riluzole. The nurse understands that this medication works in which of the following ways?

Correct Answer is D

Explanation

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