Reye’s Syndrome
Included In This Lesson
Study Tools For Reye’s Syndrome
Outline
Overview
- Rapidly progressive encephalopathy (altered brain function)
Nursing Points
General
- Primarily affects:
- Brain (cerebral edema)
- Liver (fatty changes)
- Begins shortly after a viral infection
- Influenza or varicella – chicken pox
- Associated with aspirin administration
- Early diagnosis is vital
Assessment
- History of viral illness
- Fever
- Profuse vomiting
- Signs of dehydration/shock
- Progressive neurologic decline
- Lethargy → Irritability
- Delirium
- Seizures
- Coma
- Increased ICP
- Herniation
- Elevated ammonia
- Prolonged bleeding times
- Stages 0-6
Therapeutic Management
- Supportive care based on the stage
- ABC’s
- Establish and maintain patent airway
- Treat dehydration/shock
- Assess and treat hypoglycemia
- Monitor fluid and electrolyte status
- Monitor liver function
- Bleeding time
- Ammonia levels
- Nursing Care
- Provide rest and decrease stimulation
- Monitor intake and output
- Treat dehydration but prevent cerebral edema
- Frequent neuro checks
- Seizure precautions
- Bleeding precautions
Nursing Concepts
- Intracranial Regulation
- Clotting
- Health Promotion
Patient Education
- Avoid medications with salicylates in them
- Aspirin
- Pepto-Bismol
[lesson-linker lesson=”423707,221552″ background=”white”]
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Reye’s Syndrome
Transcript
Hey everybody, in this lesson we are going to talk about Reye syndrome. Dictionaries indicate that this can be pronounced two ways, either “Rye” (like rye bread) or “Ray” so, you can take your pick! I’m going to go with “Rye”
Reye Syndrome is pretty rare, but it’s a very serious disease of the brain that progresses rapidly. It also affects the liver and there is usually a history of a viral infection (often chickenpox). There is also an association with the patient having taken aspirin to help with symptoms of the viral infection.
It isn’t fully understand why this damage is happening, but it results in edema and inflammation that leads to a neurological decline that can quickly become fatal. The CDC has developed a system to classify this rapid progression in stages 0-6.
Anytime a disease is known for progression rapidly, it’s super important to know how to recognize it early on. For Reye syndrome what you are looking for is vomiting that comes on really quickly, with a history of viral illness within the last couple weeks.
Neuro symptoms usually present 24-48 hours after the vomiting. What we need to be on the lookout for here are signs of increased intracranial pressure. I cover signs of this in the meningitis lesson, so check that out, but the main thing I want you to remember is that younger kids and infants can’t tell you when they feel weird, or when they have a headache. Lethargy and poor feeding are super important signs, but they are pretty non-specific. More specific signs are high-pitched, inconsolable crying and bulging fontanelles.
Then beyond that, you can see a rapid neurological decline, so we’re talking, seizures, drastic changes in level of consciousness, comas, and in the worst case, brain herniation from the pressure being so great in the brain. If this happens you may see dilated pupils and abnormal posturing.
These patients are likely to have very abnormal blood work- they may have low blood sugar, elevated ammonia levels and prolonged bleeding time. These two are happening because the liver isn’t functioning properly. Ammonia is a waste product that the liver usually helps the body get rid of. When the liver doesn’t get rid of it, and ammonia levels build up, patients become confused and lethargic. The liver is also responsible for producing clotting factors, so as the liver is damaged, the bodies ability to form clots is decreased causing a prolonged bleeding time.
There isn’t really a direct treatment for Reye Syndrome. Management is all about giving supportive care and monitoring the patient very closely. Supportive care will start with ABC’s. Remember hypoglycemia is common so make sure to check the glucose. In emergency situations you can always remember after your ABC’s you have DEFG which is don’t ever forget glucose!
Careful management of fluids and electrolyte are very important in preventing further complications. Frequent neuro checks are essential to keep an eye out for signs of increasing ICP. And these patients need to be on seizure precautions and bleeding precautions
Your priority nursing concepts are intracranial regulation, clotting and health promotion.
Okay, let’s recap! Reye Syndrome is a disease that isn’t fully understood where the brain and liver are damaged. It’s pretty rare, but severe and life threatening when it happens.
It is usually preceded by a viral illness and the patient having taken aspirin. Patient education is key to help prevent Reye syndrome from happening- kids should not take medications that have salicylate in them. the main ones are aspirin and pepto-bismol!
The first symptom of reye syndrome is usually vomiting and neuro symptoms follow in 1-2 days.
The most common problems to come up are dehydration, elevated ammonia levels, bleeding and brain herniation from the increased ICP.
Treatment is supportive and very closely monitoring neuro and fluid status.
That’s it for our lesson on Reye Syndrome. Make sure you check out all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing!
Plan 1
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Circulatory System
- Nervous System
- Skeletal System
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System