Medical Surgical Guillain-Barre Syndrom GBS #5

Question

The nurse is preparing a client who is being tested for Guillain-Barre syndrome by spinal tap. The client asks how the spinal tap is used in the diagnosis of Guillain-Barre syndrome. Which response by the nurse is correct?

Answers

  1. “The spinal tap sample is positive for Guillain-Barre syndrome if there is an elevation in CSF protein without an elevation in white blood cells.”
    • Rationale:

      This answer is correct because GBS is diagnosed by spinal tap. A small amount of fluid is withdrawn from the spine in the lower lumbar region and tested. In clients with GBS, there will be an elevation of CSF protein without an elevation of the white blood cells. The elevation in CSF protein is thought to be caused by inflammation of the nerve roots brought on by GBS.

  2. “A diagnosis will be made for Guillain-Barre syndrome if the spinal fluid tests positive for glucose.”
    • Rationale:

      This answer is not correct since glucose in CSF is not an indicator of GBS. Glucose found in CSF can suggest meningitis, brain hemorrhage, or diabetes.

  3. “Guillain-Barre syndrome will be suspected if there is an increase of red blood cells in the CSF.”
    • Rationale:

      This answer is not correct considering that an increase in red blood cells means there is bleeding. This connotes a brain hemorrhage of some type.

  4. “Bacteria or organisms found in the spinal tap sample indicates Guillain-Barre syndrome.”
    • Rationale:

      This answer is not correct because bacteria or organisms are a result of an infection. Infections such as syphilis or even cancer may be present.

Overview

Guillain-Barre syndrome is diagnosed by a spinal tap. A small amount of fluid is withdrawn from the spine in the lower lumbar region and tested.

Explanation

Learning Outcomes

GBS is diagnosed by spinal tap. The client will be positioned in the lateral recumbent position with their knees to the abdomen and chin to the chest. A small needle is then inserted into the spine to obtain CSF. This is done under aseptic technique. In clients with GBS, there will be an elevation of CSF protein without an elevation of the white blood cells. This elevation is thought to be caused by inflammation of the nerve roots brought on by GBS. Increased protein levels found in CSF are indicative of nerve inflammation and suggest a problem in the central nervous system.

Test Taking Tip

Know how CSF is analyzed and what the levels of protein, glucose, and bacteria indicate.

Video Rationale