In Guillain-Barré syndrome, which aspect requires close monitoring due to potential progression?

• A. Cardiovascular stability only.
• B. Renal function monitoring.
• C. Gastrointestinal motility only.
• D. Respiratory function and airway protection.

Answer: (D)

The key idea here is that Guillain-Barré syndrome can rapidly involve the muscles used for breathing. Weakness can ascend to the diaphragm and intercostal muscles, leading to ventilatory failure and loss of airway protection. Because this progression can happen quickly, close monitoring of respiratory function and the ability to protect the airway is essential.

Regularly assess how well the patient is breathing and clearing secretions. Watch for increased work of breathing, use of accessory muscles, changes in oxygen saturation, and decreased consciousness that might compromise airway protection. Objective tests are helpful: measure vital capacity and inspiratory/expiratory pressures to gauge ventilatory strength, evaluate peak cough flow to assess cough effectiveness, and monitor arterial blood gases for hypoventilation or hypoxemia. Also assess gag and swallowing reflexes, since bulbar weakness increases aspiration risk.

If signs of respiratory compromise appear, be prepared to escalate care promptly with airway management and ventilatory support. While other systems can be affected in GBS, respiratory failure is the most immediate and potentially life-threatening progression, making respiratory status the priority to monitor closely.