16 terms

Reye Syndrome

What is reye syndrome??
a life-threatening disease that leads to multisystem failure...primarily affects the liver and the brain
What does reye syndrom cause??
Liver dysfunction- Bleeding and poor blood clotting
Cerebral edema (with increased intracranial pressure)-Lethargy progressing to coma. Potential for cerebral herniation
What are the risk factors of reye syndrome??
The cause of Reye syndrome is unknown. However, research has revealed an association between using aspirin (salicylate) products for treating viral infections and
the development of Reye syndrome.
Peak incidence occurs in January, February, and March. The symptoms most often appear at the end of a viral illness (viral upper respiratory infection, varicella) but may occur earlier in the illness.
Manifestations of Stage 1
Early liver dysfunction
Brisk pupillary reaction
Ability to follow commands
Manifestations of Stage 2
Hyperactive reflexes
Sluggish pupillary response
Response to painful stimuli
Manifestations of Stage 3
Decorticate (extension)
Manifestations of Stage 4
Deeper coma
Decerebrate (flexion)
Fixed, large pupils, and loss of corneal reflexes
Brainstem dysfunction
Minimal liver dysfunction
Manifestations of Stage 5
Respiratory arrest
Absence of liver dysfunction
What are the laboratory test for reye syndrome??
Liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST]) . Elevated
Serum ammonia level . Elevated
Serum electrolytes . altered due to cerebral edema and liver changes
Serum blood glucose . Hypoglycemia
CBC may indicate low Hgb, Hct, and platelets.
Coagulation times may be extended.
What are the diagnostic procedure for reye syndrome??
Liver biopsy and CSF analysis
What is a liver biopsy??
A liver biopsy consists of taking a piece of liver tissue, via a large-bore needle, and sending this tissue to the pathology department. Care should be taken to ensure that the child's clotting studies are within normal limits prior to the procedure.
Nursing Actions
Maintain NPO status prior to the procedure.
Monitor for hemorrhage postprocedure.
Assess vital signs frequently postprocedure.
Client Education
Encourage the parents to limit the child's postprocedure activities to decrease the risk of hemorrhage.
What is csf analysis used for??
A lumbar puncture should be performed to collect CSF and rule out meningitis as a cause of symptoms (performed by a provider, usually a physician)
What is the nursing care for patient with reye syndrome??
Maintain hydration.
-Administer IV fluids as prescribed.
-Maintain accurate I&O.
-Insert indwelling urinary catheter as ordered.
Position the child.
-Avoid extreme flexion, extension, or rotation.
-Maintain the head in a midline neutral position.
-Keep the head of the bed elevated 30‹.
Monitor appropriateness of coagulation.
-Note unexplained or prolonged bleeding.
-Apply pressure after procedures.
-Prepare to administer vitamin K.
Monitor pain status and response to painful stimuli. Administer pain medications when appropriate.
Insert a nasogastric tube as ordered.
Assist with intubation and maintain a ventilator if required.
Take seizure precautions.
Keep the family informed of the child status.
Provide private time for the family to be with the child if death is imminent.
Contact support for the family.
What are the medications used for reye syndrome??
Osmotic diuretic - Mannitol (Osmitrol)
To decrease cerebral swelling, administer as prescribed.
Nursing Considerations: Monitor the child for increased intracranial pressure.
Insulin: Administer to increase glucose metabolism.
Nursing Considerations: Monitor blood glucose levels prior to insulin administration and periodically.
What are the complications of reye syndrome??
Neurologic Sequale
What is neurologic sequaelae??
Neurologic complications may include speech and/or hearing impairment, cerebral palsy, paralysis, and/or developmental delays based on the length and severity of illness.