Ineffective Breathing Pattern related to Guillain-Barre Syndrome

Nursing Care Plan for Guillain-Barre Syndrome

Nursing Diagnosis : Ineffective breathing pattern
related to:
weakness or paralysis of the respiratory muscles.

Goal / Outcomes:
Demonstrating adequate ventilation with no signs of respiratory distress, and effective breathing pattern.

Nursing Interventions:

Independent

1. Monitor the frequency, depth and symmetry of breathing. Note the increased work of breathing and skin color observations and mucous membranes.
R /: Increased respiratory distress indicate respiratory muscle fatigue and / or paralysis that may require support from mechanical ventilation.

2. Assess for changes in sensation, especially a decrease in the response.
R /: Decreased sensation often (though not always) lead to motor weakness.

3. Note the presence of respiratory fatigue during the talk if the patient is still able to speak.
R /: Is a good indicator of impaired respiratory function / decrease in lung capacity.

4. Auscultation of breath sounds, note the absence of sound or extra sound like crackles.
R /: The increase in airway resistance and accumulation of secretions or would interfere with the gas diffusion process and will lead to respiratory complications (such as pneumonia).

5. Elevate the head of your bed or put the patient in a sitting position leaning.
R /: Improving lung expansion and cough effort, decrease the work of breathing and limit the risk of aspiration of secretions.


Collaboration

6. Perform monitoring of blood gas analysis, pulse oximetry on a regular basis.
R /: Determine the effectiveness of the ventilation now and the need for / effectiveness of the intervention.

7. Perform to review the x-rays.
R /: The change is indicative of pulmonary congestion and or atelectasis.

8. Provide medication or help with the cleaning action of breathing, such as breathing exercises, chest percussion, fibrasi, and postural drainage.
R /: Improved ventilation and decrease atelectasis to mobilize secretions and improving lung expansion alveoili.

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Ineffective Airway Clearance and Ineffective Breathing Pattern NCP for Epilepsy

Definition of Epilepsy

Epilepsy is a chronic neurological disease that causes seizures periodically. The disease is caused by the normal activity of brain cells. Symptoms of seizures that appears may vary. Some people with epilepsy when seizures have an empty view. Mild seizures require treatment, because it can be dangerous in the event when doing activities like driving or swimming.

Treatments such as medical treatment and sometimes surgery is usually successful in eliminating the symptoms or reduce the frequency and intensity of seizures. In some children with epilepsy, they can overcome this condition with age.

Recently, the researchers found, epilepsy affects neurological function disrupt social functioning in the brain, the same properties are also seen in people with autism. These characteristics include impairments in social interaction and communication.

Symptoms of Epilepsy

Because epilepsy is not normally caused by the activity of brain cells, seizures can have an impact on your brain coordination process. Convulsions can result in:

• Temporary confusion.
• Uncontrolled jerking movements of the hands and feet.
• Lost consciousness completely.

Differences symptoms occur depending on the type of seizures. In many cases, people with epilepsy will tend to have this type of seizure is the same every time, so it will be the same symptoms that occur from incident to incident.

Doctors classify partial seizures or generalized, based on how abnormal brain activity begins. In some cases, seizures can be initiated by partial and later became general.

Partial Seizures

When seizures arise as a result of abnormal brain activity on the part of the brain, scientists call it partial seizures. Seizures of this type consists of two categories.

• Simple partial seizures. These seizures do not result in loss of consciousness. These seizures may be changing emotions or changing way of looking at, smell, feel, taste, or hear. These seizures can also produce buffeting parts of the body by accident, such as the hands or feet, and sensory symptoms such as tingling spontaneously, vertigo and blinking against the light.
• Complex partial seizures (complex partial seizures). These seizures resulted in the change of consciousness, it is because you lose vigilance for some time.

General Seizures

Seizures involving all parts of the brain called the general convulsions. Four types of general convulsions are:

• Absence seizures (also called petit mal). This seizure is characterized by the movement of the body has a smooth and striking, and can cause loss of consciousness briefly.
• Myoclonic seizures. These seizures usually cause a jerk or twitch suddenly in the hands and feet.
• Atonic seizures. Also known as drop attacks, these seizures cause loss of harmony with the muscles and the sudden collapse and fall.
• Tonic-clonic seizures (also called grand mal). Convulsions that have most frequently occurring intensity. Having characteristics with loss of consciousness, stiff and trembling, and loss of bladder control.

Nursing Care Plan for Epilepsy

Nursing Diagnosis : Ineffective Airway Clearance and Ineffective Breathing Pattern

related to damage nuromuskuler , tracheobronchial obstruction .

Nursing Interventions:

1) Encourage clients to release the use of objects from the mouth preformance, hammer and other tooth samples.
Rationale: lowering the risk of aspiration or the entry of foreign objects into the pharynx.

2). Place the patient in the lateral position, a flat surface, tilt the head during a seizure occurs.
Rationale: improving drainage secret, to prevent the tongue falling, and obstruct the airway.

3). Remove clothing at the neck, chest and abdomen clients.
Rational: to help clients breathe.

4). Insert the tongue into the mouth spatel clients.
Rational: to prevent biting the tongue and help perform suction mucus, and help open the airway.

5). Perform suction as indicated.
Rationale: lowering the risk of aspiration or asphyxia.

6). Collaboration in the provision of supplemental oxygen.
Rational: can decrease cerebral hypoxia, due to reduced oxygen due to vascular spasm during seizures.

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