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 Guillain-Barré Syndrome.
It occurs as a direct consequence of the disease's hallmark ascending paralysis, which weakens the diaphragm and intercostal muscles responsible for breathing.
The resulting inability to maintain adequate ventilation is known as hypoventilation, which can lead to respiratory acidosis and arrest.
Vigilant monitoring is crucial, as approximately 25-30% of GBS patients will require mechanical ventilation.

Option A: Muscle weakness is the primary clinical manifestation and hallmark symptom of GBS, not a complication. A complication is a secondary condition that develops as a result of the primary disease.
Option B: Patients with GBS are at risk for hypoventilation (inadequate breathing) due to respiratory muscle weakness, not hyperventilation (excessive breathing).
Option C: Kidney failure is not a direct or common complication of GBS. The primary systems affected are the peripheral nervous, respiratory, and autonomic systems.

Visual 1: Diagram - An illustration showing the progression of ascending paralysis in GBS, starting from the legs and moving up to the trunk, arms, and respiratory muscles. This helps visualize why respiratory failure is a major concern.
Visual 2: Infographic - A chart listing the key signs of impending respiratory failure in a GBS patient, such as a rapid decrease in vital capacity, inability to cough, use of accessory muscles, and paradoxical breathing patterns.

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.
The top nursing priority for a patient with GBS is frequent and vigilant respiratory assessment. This includes monitoring respiratory rate, depth, effort, oxygen saturation (SpO2), and serial measurements of vital capacity.
A decline in vital capacity to less than 15-20 mL/kg of body weight is a critical indicator that the patient may require elective intubation and mechanical ventilation to prevent an acute respiratory arrest.
What if? If the patient develops difficulty swallowing (dysphagia) or a weak gag reflex, the nurse must immediately make the patient NPO (nothing by mouth) and notify the provider. This indicates bulbar palsy, which significantly increases the risk of aspiration pneumonia, another serious respiratory complication.

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. A symptom is a primary feature, while a complication is a secondary problem.
Recall the pathophysiology of GBS: it is characterized by ascending paralysis (muscle weakness that starts in the legs and moves up).
Evaluate the options. 'Muscle weakness' is the defining symptom of GBS, not a complication. Therefore, option A is incorrect.
Consider how the ascending paralysis would affect the respiratory system. Weakness of the respiratory muscles would lead to ineffective breathing (hypoventilation), not over-breathing (hyperventilation). This rules out option B.
Kidney failure is not directly related to the neuromuscular pathology of GBS, making option C unlikely.

Concept Tested & Keywords

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