NORCET 8 Prelims-2025: Which of the following is the most common complication of Guillain-Barré Syndrome (GBS)?

NORCET 8 Prelims-2025

Medical & Surgical Nursing

Easy

Appeared in: NORCET 8 Prelims-2025

Explanation

Respiratory failure is the most severe and life-threatening complication of GBS.
It occurs when the ascending paralysis, a hallmark of GBS, affects the diaphragm and intercostal muscles, which are essential for breathing.
This paralysis leads to hypoventilation and an inability to maintain a clear airway or adequate oxygenation.
Sources indicate that this is a medical emergency, and a significant portion of patients (up to 30%) require mechanical ventilation to survive the acute phase.

Option A: Muscle weakness is the primary symptom and defining characteristic of GBS, not a complication. A complication is a secondary condition that arises from the primary disease.
Option B: The respiratory muscle weakness in GBS leads to hypoventilation (shallow, ineffective breathing), not hyperventilation (rapid, deep breathing).
Option C: Kidney failure is not a direct or common complication of GBS. The primary systems affected are the peripheral nervous, respiratory, and cardiovascular (autonomic) systems.

Clinical Relevance

Nursing practice connection: Knowing Complications of Guillain-Barré Syndrome (GBS) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role in managing a GBS patient is vigilant monitoring for respiratory compromise. This includes frequent checks of respiratory rate, oxygen saturation, and, crucially, bedside pulmonary function tests like vital capacity.
Early detection of declining respiratory function allows for timely intervention (elective intubation) which has better outcomes than emergency intubation during a respiratory arrest.
What if? If a GBS patient's vital capacity drops below 15 mL/kg and they show signs of fatigue (e.g., use of accessory muscles, paradoxical breathing), the nurse must immediately notify the physician and prepare for intubation and mechanical ventilation. This is a critical safety action.

How to Approach the Question

First, identify the keywords in the question: 'most common complication' and 'Guillain-Barré Syndrome (GBS)'.
The key is to differentiate between a 'symptom' of a disease and a 'complication' that arises from it.
Analyze the options. Muscle weakness is the fundamental problem in GBS—it's what the disease IS. Therefore, it's a symptom, not a complication.
Consider the pathophysiology of GBS: ascending paralysis. Think about what happens when this paralysis reaches the vital organs in the torso.
When the paralysis affects the diaphragm and intercostal muscles, breathing becomes impaired. This impairment is a secondary event and a direct consequence of the primary disease, making respiratory failure a complication.
Eliminate the other options: Hyperventilation is the opposite of the expected finding (hypoventilation), and kidney failure is not a typical GBS complication.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 137-139

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