Guillain-Barre Syndrome

[kathy_rn]

I'm an ICU nurse and for the last 2 days I had a GBS pt. Neuro is not our specialty and they may transfer the pt to another hospital; however, until that happens we have to take care of this person.
I have a question regarding the pt's mental status.
In agree w/ the daughter, the pt is a normal, coherent person. There is no underlying dementia, no mental problems of any kind, pt has never taken any antidepressants, was in good health until hospitalization. In spite of being elderly, the person is a very lucid person who lives a normal life, walks, talks, cooks, plays w/ grandchildren and so on. The confusion apparently started (in agree w/ daughter's perception) right after we started given immune globulin to the pt. I had this person as my pt for the last 2 nights and it was a nightmare. The person had visual hallucinations, pulled out tubes and lines that had to be reinserted, was completely restless, there was no comfort measure that would sooth her, no pain medication or nerve pain medication that would work, nothing. The pt would grab the gown and chew on it, would grab monitoring equipment and take it out, would scratch the skin to the point that I had to put mittens on or there would be blood everywhere. It was terrible. Nothing would help the pt. As a nurse I was really frustrated (and exhausted beyon belief) because I just hate when my pts are uncomfortable and I feel powerless. I called the doctor and we tried to switch meds and comfort measures but nothing. Last night the daughter stayed to help and having a familiar face helped a little but the pt continued to be agitated, restless, hallucinating.

I'm trying to research about the meds like immune globulin and see if there is/are side effects that would justify this change of mental status in my pt. As an ICU nurse, I'm aware of ICU psychosis and sundowners and I know that it can be the case w/ this pt. Also it may be that the daughter did not notice mental changes in her parent (which I honestly doubt because for the most part, family members know their family and the daughter would be aware if any signs of dementia would be present in a daily basis)....but it may be something that just started or came up because the hospitalization... I don't know. I was just wondering if GBS has anything to do with the change in mental status on my pt.
Any ideas/suggestions are welcome.
Thank you everyone.