The neuroscience aspects of care associated with a 365-day hospitalization of a 25-year-old, C1 quadriplegic are presented in the following article. The patient and his family have given permission to present specifics of his case and to use his name and photograph. This report does not consider all of the technical aspects of this patient's care. Our focus is on procedures and problems concomitant with phrenic stimulation and with discharge planning.
The primary purpose of the present study was to determine if altering the timing of phenytoin administration in relation to delivery of tube feedings increased serum phenytoin levels. Stopping tube feedings for two hours before and two hours after administration is a procedure that nurses could employ independently for better patient care. However, this adds an extra procedure to the nurse's already busy routine. It also requires the nurse to adjust either the tube feeding flow rate or bolus amount in order to deliver the same amount of calories per day. Based on this study, it appears that this intervention procedure is not effective for the patient and is time-consuming for the nurse. Instead, the focus for increasing phenytoin serum levels in patients receiving tube feedings should probably be on increasing the dosage.
Even though maternal Guillain-Barré syndrome is very rare, there may be approximately a 6 percent chance of its development in a pregnant woman. There are still many unanswered questions as to why it develops during pregnancy. Although limited information is available for assistance to victims of maternal Guillain-Barré syndrome, the study of these cases is continuing.
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