Guillain-Barre Syndrome Nursing Care Plans: GBS Nursing Diagnosis and Interventions

What is Guillain-Barre Syndrome?

Guillain-Barre Syndrome (GBS), also known as acute inflammatory demyelinating polyradiculopathy, is a rare autoimmune disorder affecting the peripheral nervous system. In GBS, the body’s immune system mistakenly attacks the myelin sheath, the protective covering of nerves, leading to nerve damage. This damage disrupts nerve signals, causing muscle weakness, numbness, and in severe cases, paralysis. While the precise etiology of GBS remains elusive, it is frequently triggered by a preceding infection, such as viral or bacterial infections, or, less commonly, by vaccinations. The syndrome is characterized by a rapid onset of symmetrical muscle weakness that typically begins in the legs and ascends to the upper body. Sensory symptoms are usually less pronounced than motor dysfunction.

The clinical spectrum of GBS varies considerably, ranging from mild weakness to complete paralysis requiring mechanical ventilation. The disease course is typically monophasic, with symptoms progressing for up to four weeks, followed by a plateau phase, and then a recovery phase that can last from months to years. While most individuals with GBS achieve substantial recovery, some may experience residual weakness or neurological deficits. GBS can affect individuals of all ages but is more prevalent in adults and older adults. Prompt diagnosis and supportive care are crucial for managing GBS and minimizing potential complications. Treatment strategies focus on managing symptoms, supporting bodily functions during the acute phase, and facilitating neurological recovery through rehabilitation.

Nursing Care Plans and Management

Nursing care for a patient with Guillain-Barre Syndrome is multifaceted, requiring a comprehensive approach to address the diverse physiological and psychological challenges posed by this condition. The primary goals of nursing care are to support respiratory function, manage pain, prevent complications of immobility, maintain nutritional status, provide emotional support, and facilitate rehabilitation to maximize functional recovery. A patient-centered approach is essential, involving the patient and their family in care planning and decision-making.

Effective nursing care planning for GBS necessitates a thorough understanding of the disease process, potential complications, and individualized patient needs. This includes meticulous assessment, accurate nursing diagnoses, well-defined goals, and evidence-based interventions. Collaboration with an interdisciplinary team, including physicians, physical therapists, occupational therapists, speech therapists, and respiratory therapists, is paramount to ensure holistic and coordinated care.

Nursing Problem Priorities

The immediate nursing priorities for patients diagnosed with Guillain-Barre Syndrome are centered on managing life-threatening complications and providing supportive care. These priorities include:

Maintaining Respiratory Function: GBS can compromise respiratory muscles, leading to respiratory insufficiency or failure. Continuous monitoring of respiratory rate, depth, and oxygen saturation is critical. Assisting with ventilation and airway management is a primary concern.
Neurological Monitoring: Regular assessment of neurological status, including motor strength, sensory function, and cranial nerve function, is essential to detect disease progression or complications.
Pain Management: Neuropathic pain is a significant symptom in GBS. Effective pain management strategies are crucial for patient comfort and participation in rehabilitation.
Preventing Complications of Immobility: Paralysis and weakness increase the risk of complications such as deep vein thrombosis (DVT), pressure ulcers, and contractures. Proactive measures to prevent these complications are vital.
Nutritional Support: Dysphagia and generalized weakness can impair nutritional intake. Maintaining adequate nutrition and hydration is necessary for recovery.
Psychological and Emotional Support: The rapid onset of paralysis and uncertainty of prognosis can cause significant anxiety and emotional distress for patients and families. Providing emotional support and education is crucial.
Facilitating Rehabilitation: Early initiation of rehabilitation is essential to promote functional recovery and minimize long-term disability.

Nursing Assessment

A comprehensive nursing assessment is the cornerstone of effective care for patients with Guillain-Barre Syndrome. This assessment should encompass both subjective and objective data to gain a holistic understanding of the patient’s condition.

Assess for the following subjective and objective data:

Subjective Data:

Patient history of recent infections (respiratory, gastrointestinal).
Patient reports of ascending weakness, starting in the legs and moving upwards.
Patient description of sensory changes, such as tingling, numbness, or pain.
Patient complaints of fatigue, difficulty with balance or coordination.
Patient’s perception of pain, its location, character, and intensity.
Patient’s emotional state, including anxiety, fear, or frustration.
Patient’s understanding of the diagnosis and treatment plan.

Objective Data:

Neurological Assessment:
- Motor strength assessment using a standardized scale (e.g., Medical Research Council scale).
- Deep tendon reflex assessment (often diminished or absent).
- Cranial nerve assessment (especially facial, glossopharyngeal, vagus, and accessory nerves).
- Sensory examination (light touch, pain, temperature, proprioception).
- Assessment of coordination and balance.
Respiratory Assessment:
- Respiratory rate, rhythm, and depth.
- Oxygen saturation (SpO2).
- Auscultation of breath sounds.
- Assessment of cough effectiveness.
- Signs of respiratory distress (dyspnea, use of accessory muscles).
- Arterial blood gas (ABG) analysis if indicated.
- Forced vital capacity (FVC) and negative inspiratory force (NIF) measurements to assess respiratory muscle strength.
Cardiovascular Assessment:
- Heart rate and rhythm.
- Blood pressure (monitor for autonomic dysfunction, including fluctuations).
- Electrocardiogram (ECG) monitoring if indicated.
Skin Assessment:
- Inspect skin for pressure ulcers, especially bony prominences.
- Assess skin integrity and hydration.
Musculoskeletal Assessment:
- Range of motion in all extremities.
- Presence of muscle atrophy or contractures.
Gastrointestinal and Genitourinary Assessment:
- Assess bowel sounds and patterns (monitor for constipation or bowel incontinence).
- Assess bladder function (monitor for urinary retention or incontinence).
- Monitor fluid intake and output.
Pain Assessment:
- Use a validated pain scale (e.g., Numeric Rating Scale, Visual Analog Scale).
- Assess pain location, character, intensity, aggravating and relieving factors.
Psychosocial Assessment:
- Assess patient’s emotional state, coping mechanisms, and support system.
- Evaluate patient’s and family’s anxiety and understanding of the condition.

Nursing Diagnosis

Based on a comprehensive nursing assessment, several nursing diagnoses may be relevant for a patient with Guillain-Barre Syndrome. These diagnoses provide a framework for planning and implementing individualized nursing care. Prioritizing nursing diagnoses is crucial, with immediate attention given to life-threatening issues such as respiratory compromise. Key gbs nursing diagnoses include:

Ineffective Breathing Pattern related to respiratory muscle weakness secondary to Guillain-Barre Syndrome, as evidenced by shallow respirations, decreased respiratory rate, and decreased oxygen saturation.
Impaired Physical Mobility related to neuromuscular impairment secondary to Guillain-Barre Syndrome, as evidenced by decreased muscle strength, paralysis, and difficulty with voluntary movement.
Acute Pain related to nerve damage and inflammation secondary to Guillain-Barre Syndrome, as evidenced by patient report of pain, facial grimacing, and restlessness.
Impaired Swallowing related to cranial nerve dysfunction secondary to Guillain-Barre Syndrome, as evidenced by coughing or choking when eating, drooling, and weak cough.
Risk for Aspiration related to impaired swallowing and decreased cough reflex secondary to Guillain-Barre Syndrome.
Impaired Urinary Elimination related to autonomic nervous system dysfunction secondary to Guillain-Barre Syndrome, as evidenced by urinary retention or incontinence.
Risk for Constipation related to decreased mobility and autonomic nervous system dysfunction secondary to Guillain-Barre Syndrome.
Risk for Impaired Skin Integrity related to immobility and sensory deficits secondary to Guillain-Barre Syndrome.
Anxiety related to sudden onset of paralysis, uncertainty of prognosis, and hospitalization secondary to Guillain-Barre Syndrome, as evidenced by patient report of anxiety, restlessness, and increased heart rate.
Deficient Knowledge related to Guillain-Barre Syndrome, treatment, and rehabilitation, as evidenced by patient questions and expressed concerns about the condition.

It is important to note that this is not an exhaustive list, and other nursing diagnoses may be appropriate based on the individual patient’s presentation and needs. The selection of the most relevant gbs nursing diagnoses should be based on the nurse’s clinical judgment and a thorough assessment of the patient.

Nursing Goals

The establishment of clear and measurable goals is essential for guiding nursing interventions and evaluating patient outcomes. Goals for patients with Guillain-Barre Syndrome are individualized and should be developed in collaboration with the patient and their family. Examples of nursing goals include:

Respiratory Function: The patient will maintain an effective breathing pattern with adequate oxygenation, as evidenced by respiratory rate within normal limits, oxygen saturation ≥ 95%, and clear breath sounds.
Physical Mobility: The patient will achieve and maintain optimal physical mobility within the limitations of their condition, as evidenced by participation in physical therapy, performance of range of motion exercises, and use of assistive devices as needed.
Pain Management: The patient will report pain at a manageable level (specify pain rating on a pain scale), as evidenced by verbal report, relaxed facial expression, and participation in activities.
Swallowing Function: The patient will maintain safe swallowing function without aspiration, as evidenced by absence of coughing or choking during meals, and ability to manage oral secretions.
Urinary Elimination: The patient will maintain a regular pattern of urinary elimination without retention or incontinence, as evidenced by balanced intake and output, and absence of bladder distention.
Bowel Elimination: The patient will maintain regular bowel elimination patterns without constipation, as evidenced by passage of soft, formed stools at regular intervals.
Skin Integrity: The patient will maintain intact skin integrity without pressure ulcers, as evidenced by absence of redness or skin breakdown.
Anxiety Reduction: The patient will demonstrate reduced anxiety levels, as evidenced by verbalization of decreased anxiety, relaxed body language, and participation in coping strategies.
Knowledge Enhancement: The patient and family will verbalize understanding of Guillain-Barre Syndrome, treatment plan, and rehabilitation process, as evidenced by answering questions accurately and actively participating in care.

These goals serve as a roadmap for nursing care and provide a framework for evaluating the effectiveness of interventions. Goals should be regularly reviewed and adjusted based on the patient’s progress and changing needs.

Nursing Interventions and Actions

Therapeutic nursing interventions for patients with Guillain-Barre syndrome are aimed at addressing the identified nursing diagnoses and achieving the established goals. These interventions are evidence-based and tailored to meet the individual needs of each patient.

1. Enhancing Respiratory Function and Improving Breathing Patterns

Respiratory compromise is a critical concern in GBS due to muscle weakness affecting respiration. Nursing interventions focus on maintaining a patent airway, promoting effective breathing, and preventing respiratory complications.

Assess respiratory rate, depth, symmetry, and effort every 1-2 hours and as needed. Monitor oxygen saturation continuously. Frequent assessments allow for early detection of respiratory distress and the need for intervention. Changes in respiratory parameters can indicate worsening muscle weakness and impending respiratory failure.

Auscultate lung sounds for adventitious sounds (wheezes, crackles, rhonchi). Abnormal lung sounds may indicate airway obstruction, secretions, or developing pneumonia.

Monitor arterial blood gases (ABGs) and pulse oximetry. ABGs provide a direct measure of oxygenation and ventilation, while pulse oximetry offers continuous non-invasive monitoring of oxygen saturation.

Elevate the head of the bed to 30-45 degrees. Semi-Fowler’s position promotes lung expansion and diaphragmatic excursion, facilitating easier breathing.

Encourage deep breathing and coughing exercises every 2 hours while awake. Deep breathing expands alveoli and improves gas exchange. Coughing helps mobilize and clear airway secretions, reducing the risk of pneumonia.

Administer supplemental oxygen as prescribed, monitoring response. Oxygen therapy corrects hypoxemia and ensures adequate oxygen delivery to tissues.

Provide chest physiotherapy (percussion, vibration, postural drainage) as ordered. Chest physiotherapy helps mobilize and drain pulmonary secretions, preventing atelectasis and pneumonia.

Prepare for and assist with intubation and mechanical ventilation if respiratory failure occurs. Mechanical ventilation provides respiratory support when the patient’s respiratory muscles are too weak to maintain adequate oxygenation and ventilation.

Suction airway secretions as needed, using sterile technique. Suctioning removes excess secretions from the airway, maintaining patency and preventing aspiration and infection.

Monitor for signs of respiratory infection (fever, increased sputum production, change in sputum color, increased respiratory distress). Early detection and treatment of respiratory infections are crucial to prevent further respiratory compromise.

Collaborate with respiratory therapists for respiratory management and weaning from mechanical ventilation. Respiratory therapists are experts in airway management and mechanical ventilation and play a vital role in optimizing respiratory care.

2. Providing Adequate Pain Relief and Comfort

Pain management is essential in GBS to improve patient comfort and facilitate participation in rehabilitation. Pain in GBS is often neuropathic and can be severe.

Assess pain level, location, characteristics, and aggravating/relieving factors using a pain scale regularly. A comprehensive pain assessment is crucial to understand the patient’s pain experience and guide pain management strategies.

Administer analgesics as prescribed, considering the type and severity of pain. Opioids, non-opioids, and neuropathic pain medications may be used. Analgesics are essential to reduce pain and improve comfort. Neuropathic pain medications, such as gabapentin or pregabalin, may be particularly effective for nerve pain in GBS.

Monitor for side effects of pain medications, such as respiratory depression, sedation, constipation. Opioids, in particular, can cause respiratory depression and other side effects, requiring careful monitoring and management.

Provide non-pharmacological pain relief measures, such as positioning, massage, warm or cold packs, and distraction techniques. Non-pharmacological methods can complement pharmacological pain management and reduce reliance on medications.

Ensure proper body alignment and support extremities with pillows. Proper positioning and support can reduce pressure on painful areas and promote comfort.

Provide gentle range of motion exercises as tolerated to prevent stiffness and pain associated with immobility. Gentle movement can help prevent joint stiffness and reduce pain associated with prolonged immobility.

Create a quiet and restful environment to promote relaxation and reduce pain perception. A calm and restful environment can enhance the effectiveness of pain management strategies.

Educate the patient and family about pain management strategies and the importance of reporting pain. Patient education empowers patients to actively participate in their pain management and improve communication with healthcare providers.

3. Enhancing Physical Mobility

Maintaining physical mobility and preventing complications of immobility are crucial aspects of GBS nursing care.

Assess motor strength, range of motion, and functional mobility at least daily. Regular assessment of motor function helps track disease progression, recovery, and the effectiveness of interventions.

Perform passive range of motion exercises to all extremities at least twice daily. Passive ROM exercises prevent joint stiffness, contractures, and muscle atrophy in paralyzed limbs.

Encourage active range of motion exercises as the patient’s strength improves. Active ROM exercises help strengthen muscles and improve joint mobility as recovery progresses.

Position the patient to prevent contractures and foot drop. Use splints or braces as prescribed. Proper positioning and splinting help maintain functional alignment and prevent deformities.

Reposition the patient at least every 2 hours and more frequently if needed. Frequent repositioning prevents pressure ulcers and promotes skin integrity.

Use pressure-relieving devices, such as air mattresses or specialty beds. Pressure-relieving devices reduce pressure on bony prominences and minimize the risk of pressure ulcer development.

Provide assistance with transfers and ambulation as tolerated, using appropriate assistive devices (e.g., walkers, wheelchairs). Assisting with mobility promotes independence and reduces the risk of falls and complications of immobility.

Collaborate with physical therapists to develop and implement a comprehensive rehabilitation program. Physical therapists are essential members of the GBS care team and provide specialized expertise in mobility and rehabilitation.

Monitor for signs of deep vein thrombosis (DVT) (swelling, redness, pain in extremities). Immobility increases the risk of DVT. Early detection and prevention are crucial.

Apply sequential compression devices (SCDs) or administer prophylactic anticoagulants as prescribed to prevent DVT. Mechanical and pharmacological DVT prophylaxis measures reduce the risk of thromboembolic complications.

4. Improving Bladder and Urinary Elimination

Autonomic nervous system dysfunction in GBS can lead to urinary retention or incontinence. Nursing interventions focus on maintaining bladder function and preventing complications.

Assess urinary output, frequency, and bladder distention regularly. Monitoring urinary function helps detect urinary retention or incontinence early.

Monitor fluid intake and output. Maintaining adequate hydration and monitoring fluid balance are important for overall health and urinary function.

Palpate the bladder for distention every 4-6 hours. Bladder palpation helps identify urinary retention.

Encourage the patient to void every 2-3 hours and as needed. Regular voiding helps prevent bladder overdistention.

Implement bladder training program as appropriate, including timed voiding and prompted voiding. Bladder training can help restore bladder control and reduce incontinence.

Catheterize for residual urine volume if indicated to assess for urinary retention. Post-void residual measurement helps quantify urinary retention.

Insert an indwelling urinary catheter if urinary retention is significant and persistent. Indwelling catheters may be necessary to manage severe urinary retention and prevent bladder damage.

Provide meticulous perineal care, especially if an indwelling catheter is in place, to prevent urinary tract infections (UTIs). Proper hygiene reduces the risk of catheter-associated UTIs.

Monitor for signs of urinary tract infection (fever, dysuria, cloudy or foul-smelling urine). Early detection and treatment of UTIs are important to prevent complications.

Educate the patient and family about bladder management strategies and signs of UTI. Patient education empowers patients and families to participate in bladder management and recognize potential problems.

5. Reducing Anxiety and Providing Emotional Support

The sudden onset and potential severity of GBS can cause significant anxiety and emotional distress. Nursing interventions aim to provide emotional support, reduce anxiety, and promote coping.

Assess the patient’s and family’s anxiety level, coping mechanisms, and support systems. Understanding the patient’s and family’s emotional state and resources is crucial for providing effective support.

Provide a calm and supportive environment. A calm and reassuring environment can help reduce anxiety and promote a sense of security.

Encourage the patient and family to express their feelings and concerns. Providing opportunities for verbalization of emotions can help patients and families process their experiences and reduce emotional distress.

Provide accurate and honest information about GBS, treatment, and prognosis at the patient’s and family’s level of understanding. Knowledge can reduce anxiety associated with uncertainty and fear of the unknown.

Explain all procedures and treatments in detail before they are performed. Clear explanations can reduce anxiety related to unfamiliar procedures.

Use therapeutic communication techniques, such as active listening, empathy, and reassurance. Therapeutic communication builds trust and rapport, facilitating emotional support.

Facilitate contact with family and friends. Social support is crucial for coping with illness and reducing anxiety.

Involve the patient and family in care planning and decision-making. Involving patients and families in care decisions promotes a sense of control and reduces anxiety.

Provide referrals to social workers, counselors, or support groups as needed. Specialized support services can provide additional emotional support and coping strategies.

Teach relaxation techniques, such as deep breathing exercises or guided imagery. Relaxation techniques can help reduce anxiety and promote a sense of calm.

6. Initiating Patient Education and Health Teachings

Patient education is essential to empower patients and families to actively participate in their care, manage symptoms, and promote recovery.

Provide comprehensive education about Guillain-Barre Syndrome, including its causes, symptoms, disease course, treatment options, and prognosis. Thorough education enhances understanding and reduces anxiety.

Educate patients and families about the importance of early recognition of symptoms and seeking prompt medical attention. Early diagnosis and treatment are crucial for optimizing outcomes.

Teach patients and families about respiratory management techniques, including deep breathing and coughing exercises, and the importance of reporting any signs of respiratory distress. Respiratory education empowers patients and families to monitor and manage respiratory function effectively.

Instruct patients and families on pain management strategies, including medication administration, non-pharmacological pain relief measures, and the importance of reporting pain. Pain management education improves patient comfort and participation in rehabilitation.

Educate patients and families about mobility and rehabilitation, including range of motion exercises, positioning techniques, transfer techniques, and the importance of physical therapy. Mobility education promotes functional recovery and prevents complications of immobility.

Teach patients and families about bladder and bowel management strategies, including fluid intake, voiding schedules, and signs of urinary tract infections or constipation. Bladder and bowel education empowers patients and families to manage elimination issues effectively.

Provide education on skin care and pressure ulcer prevention techniques. Skin care education reduces the risk of pressure ulcers and maintains skin integrity.

Discuss potential long-term effects of GBS and the importance of ongoing rehabilitation and follow-up care. Long-term education prepares patients and families for the recovery process and promotes adherence to follow-up care.

Provide written materials and resources to reinforce teaching and provide ongoing support. Written materials serve as a valuable resource for patients and families to refer to after discharge.

Connect patients and families with GBS support groups and organizations. Support groups provide peer support, information, and resources for patients and families affected by GBS.

7. Administer Medications and Provide Pharmacologic Support

Pharmacological interventions for GBS aim to modulate the immune response and manage symptoms.

Administer intravenous immunoglobulin (IVIG) as prescribed. IVIG is a primary treatment for GBS that helps modulate the immune system and reduce nerve damage. Monitor for infusion reactions during IVIG administration.

Prepare for and assist with plasmapheresis (plasma exchange) if prescribed. Plasmapheresis is another treatment option that removes harmful antibodies from the blood. Monitor for complications during and after plasmapheresis.

Administer analgesics as prescribed for pain management. Analgesics, including opioids, non-opioids, and neuropathic pain medications, are used to manage pain effectively.

Administer prophylactic anticoagulants (e.g., heparin, enoxaparin) as prescribed to prevent DVT. Anticoagulants reduce the risk of thromboembolic complications associated with immobility.

Administer stool softeners and laxatives as needed to prevent constipation. Bowel management is important to prevent constipation associated with immobility and medications.

Administer anticholinergic medications if prescribed for urinary incontinence. Anticholinergics can help manage overactive bladder and urinary incontinence.

Monitor for therapeutic effects and side effects of all medications. Close monitoring is essential to ensure medication effectiveness and detect and manage any adverse effects.

8. Monitoring Results of Diagnostic and Laboratory Procedures

Diagnostic and laboratory procedures are used to confirm the diagnosis of GBS and monitor disease progression and complications.

Monitor results of nerve conduction studies (NCS) and electromyography (EMG). NCS and EMG assess nerve function and help confirm the diagnosis of GBS and monitor nerve recovery.

Monitor cerebrospinal fluid (CSF) analysis results, particularly protein levels. Elevated CSF protein is a characteristic finding in GBS.

Monitor complete blood count (CBC), electrolytes, and renal function tests. These tests provide baseline data and monitor for potential complications.

Monitor arterial blood gases (ABGs) and pulse oximetry to assess respiratory status. Respiratory monitoring is crucial for detecting and managing respiratory compromise.

Monitor electrocardiogram (ECG) for cardiac arrhythmias. ECG monitoring may be indicated to assess for autonomic dysfunction affecting cardiac rhythm.

Review and report any abnormal laboratory or diagnostic findings to the physician promptly. Timely communication of abnormal results allows for prompt intervention and management.

9. Assessing and Monitoring for Potential Complications

Proactive monitoring for potential complications is essential to ensure early detection and prompt management, minimizing their impact on patient outcomes.

Monitor for signs and symptoms of respiratory failure (increased respiratory distress, decreased oxygen saturation, altered mental status). Respiratory failure is a life-threatening complication requiring immediate intervention.

Assess for signs and symptoms of autonomic dysfunction (fluctuations in blood pressure, heart rate abnormalities, cardiac arrhythmias, bowel and bladder dysfunction). Autonomic dysfunction can lead to serious cardiovascular and other complications.

Monitor for signs and symptoms of infection (fever, increased white blood cell count, localized signs of infection). Infection can exacerbate GBS and delay recovery.

Assess for signs and symptoms of deep vein thrombosis (DVT) and pulmonary embolism (PE) (leg swelling, pain, redness, chest pain, shortness of breath). Thromboembolic complications are a risk due to immobility.

Monitor for signs of pressure ulcer development (redness, skin breakdown over bony prominences). Pressure ulcers are a preventable complication of immobility.

Assess for nutritional status and monitor for signs of malnutrition or dehydration. Maintaining adequate nutrition is crucial for recovery.

Monitor psychosocial status and assess for signs of depression, anxiety, or emotional distress. Psychosocial support is essential for coping with the emotional impact of GBS.

Regularly evaluate swallowing function and monitor for signs of aspiration. Swallowing difficulties can lead to aspiration pneumonia.

Document all assessments, interventions, and patient responses accurately and promptly. Thorough documentation ensures continuity of care and facilitates communication among healthcare providers.

Recommended Resources

For further information and resources on Guillain-Barre Syndrome and nursing care, consider the following:

Guillain-Barre Syndrome Support Groups: These organizations offer valuable support, information, and resources for patients and families affected by GBS.
National Institute of Neurological Disorders and Stroke (NINDS): Provides comprehensive information about GBS, research updates, and clinical trials.
Nursing Diagnosis Handbooks: Resources such as “Ackley and Ladwig’s Nursing Diagnosis Handbook” and “Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care” offer detailed information on nursing diagnoses, interventions, and care planning for neurological conditions like GBS.

References

Ackley, B. J., & Ladwig, G. B. (2020). Nursing diagnosis handbook: An evidence-based guide to planning care. Elsevier.
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales. F.A. Davis Company.
Wilkinson, J. M. (2020). Nursing diagnosis manual: Planning, individualizing, and documenting client care. F.A. Davis Company.
Nurseslabs. (2023). Guillain-Barre Syndrome Nursing Care Plans. https://nurseslabs.com/guillain-barre-syndrome-nursing-care-plans/