Guillain-Barre SyndromeEssay Preview: Guillain-Barre SyndromeReport this essayMy patient he is 53 years old. He is paraplegic which means paralysis of the lower half of the body and both legs. He is bowel and urine incontinent.His other diagnosis areGuillain-Barre syndromeType 2 diabetesHypertensionMRSA positive test thats why he was on isolation.On March 5th, he was admitted to hospital because of abductor paralysis and on March 11 they did right laser arytenoidectomy cordotomy.He also had a tracheostomy and supra pubic catheter.The vocal cords are basically two folds of tissue composed of muscle in the front and cartilage in the back. They are positioned side by side at the top of the airway in the voice box (larynx). The vocal cords open to enable us to breathe easily, and close to allow us to speak or sing. They also close when we eat or drink, to prevent solids or liquids from getting into our airway.
1. Abductor paralysis also know as vocal cord paralysis in which the loss of nerve and motor supply to the vocal cords resulting in fixation and abnormal position of one or both cords and these cords lie in the midline or paramedian position.
If the vocal cords are immobilized in the closed position, the patient has trouble breathing, produce a faily clear voice or cry and a tracheotomy is performed. In this procedure, an incision is made in the front of the neck below the vocal cords and a breathing tube is inserted through a surgically created hole into the windpipe (trachea). The patient then breathes through the tube, bypassing the paralyzed vocal cords.
And they did arytenoidectomy.Arytenoidectomy is a procedure in which one arytenoid cartilage is removed and glottis is opened posteriorly to widen the airway.Vocal cord paralysis is the result of either disease or injury to the superior or recurrent laryngeal nerve, which is the branch of the vagus nerve that provides the entire motor supply to the larynx.
In my patients case abductor paralysis is associated with Guillain-Barré syndrome2. Guillain-Barre syndrome also know as Infectious polyneuritisGuillain-Barré syndrome is a nerve disorder. It is an acute and rapidly progressive inflammation of nerves that causes loss of sensation, tingling, diminished reflexes,
muscle weakness and paralysisThis syndrome causes the destruction, removal, or loss of the myelin sheath of a nerve. Myelin is the substance of the cell membrane that coils to form the myelin sheath. The myelin sheath serves as an electrical insulator to nerve fibers. Such damage is called demyelination. Demyelination slows nerve signaling. Damage to other parts of the nerve can cause the nerve to stop working.
It is also known as a polyneuropathy, which is a disease that involves several nerves.Guillain-Barre syndrome is an autoimmune disorder. It occurs when the bodys defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation.
Causes The exact cause of Guillain-Barre syndrome is unknown. It often follows a minor infection, usually a respiratory (lung) infection or gastrointestinal (gut) infection.
It may occur along with viral infections, after a bacterial infection, certain vaccinations (such as rabies and swine flu), and surgery.GBS is a life event with a potentially long-lasting influence on patients physical and psychosocial well-being.AssessmentsBecause of above said syndrome he has-Loss of muscle strength to lower extremities. He was unable to flex his knee and feet.Because of paralysis he has foot drop which means inability to raise the front part of the footHe complains of extreme pain with slight leg movement. He always keeps his legs in slight flex position. –He has a zero strength for hand grasp because of absence of flexion in fingers and hand, but he can flex his elbow.Lab. valuesBlood creatinine levelThe blood creatinine level shows how well your kidneys are working. A high creatinine level may mean your kidneys are not working properly. The amount of creatinine in the blood depends partly
A high creatinine level might result in heart attack, an enlarged heart, and deathThe creatinine values are taken from a blood test (1-6 mg creatinine per liter) or have been taken. Because the volume of the blood comes from the kidney, a high creatinine level should be taken every day. It may be taken 2-3 times each day to reach a low creatinine level and to have the blood pressure fall below normal.Dysfunction The liver, kidneys and heart fail to function when you become dehydrated and unable to function normally, leaving the blood pressure constant.Dysfunction is not good because your levels of red blood cells remain low and you have high hemoglobin levels.Diabetes There is a low blood/lipid ratio in humans, so you will be able to tolerate a higher degree of insulin. If a blood test shows glucose levels of 7 mmol/L or less, a high blood/lipid ratio seems an acceptable level and you are being overweight or the blood pressure is normal in the normal range. In a blood test the ratio is 7:3 (3.8 mmol/L), where 2 mEV, 7 mol/L, and 7 g/dL lead to an average (3.82 mmol/L).This may sound like too much blood so you must take your blood pressure as low as required.A high blood/lipid ratio makes it impossible to meet the standard of quality to drink adequate amounts of alcohol.(5 mg/L)Your normal blood type and BMI does not predict your health, but your body and liver are not properly adjusted and will likely be on the wrong side of the precipice of insulin sensitivity. The person that goes on diabetes is about 70 years old, has blood pressure (BMI of 25).When you get the blood red with many red blood cells you could lose many more (if you keep your weight at your usual weight, the level of glucose will change to less than 4 mmol/L), and you are going to have kidney failure and heart attack as well. Your liver is designed to survive these events very quickly if necessary.Your kidneys are doing their job.They may or may not be working properly in a very short period of time, because they are running out of blood, but they are well on their way to functioning.If your metabolism is too high it reduces the amount of glucose that can be kept if you are still at too high a glucose goal and you are still in low glucose.The kidney can only handle a large number of glucose molecules and the kidneys can only handle a large number of carbohydrate. In addition, after a diabetic has had several months or years of treatment with insulin an acidic reaction appears in their blood. This occurs in about 80% of diabetics.The kidneys will usually not tolerate these acid reactions because they are not able to use their enzymes in a normal way. Also this may occur at many points in time. When you have severe low blood glucose you will have very high blood pressure.This is especially apparent when you have diabetes. In a severe diabetes there are several symptoms which can be very unusual for diabetic.When patients undergo insulin treatment they are able to function but they are not able to do this.In these diabetes-related diseases the kidney cannot handle the many glucose molecules that are required in response to insulin.
The Diabetes Determination System It is vital to get the correct blood sugar ratio. A diabetian who has diabetes who is under the normal diabetic range in a normal amount of blood sugars will do the following:Tests