Reye’s syndrome is a rare condition that causes swelling of the liver and brain and most often occurs in children following a viral illness such as flu or chickenpox in combination with taking aspirin. Reye’s syndrome is a serious condition with no known cure that can be life threatening. Treatment involves symptomatic care and support.
Certain toxins, usually salicylates (aspirin), attack the liver cells causing them not to filter and regulate blood sugar and ammonia levels. As the blood sugar level drops from vomiting, the ammonia and acidity levels rise causing the liver and brain to swell and may result in seizures or coma. Studies show that children who take aspirin or aspirin-containing products during or following a viral illness, specifically influenza and chickenpox, are at greater risk of developing Reye’s syndrome.
Patient will maintain adequate respiratory status and optimal neurologic functioning; patient will maintain adequate fluid balance
Assess and monitor vital signs
Determine oxygenation and respiratory status. Get baseline data to determine effectiveness of interventions.
Changes in temperature can indicate damage to the brain and difficulty regulating temperature.
Perform complete assessment of systems including neurological status
Help determine staging of disorder and treatment required. Seizures, loss of reflexes, posturing and lack of pupil reaction indicate more advanced neurologic involvement.
Monitor blood glucose levels
Drops in blood glucose can indicate elevated ammonia levels. Hyper- and hypoglycemia can result in further complications of the condition.
Initiate IV and monitor fluid balance
Maintain hydration with presence of vomiting or diarrhea. Watch for signs of fluid overload.
Initiate seizure safety precautions per facility protocol
Place infant or toddler in crib with padding, raise bed rails for older children in case of seizures. Keep oxygen and suction readily available
Assess for signs of increased intracranial pressure
Monitoring may be done with intraventricular catheter. Prevent swelling of the brain if possible to reduce risk of brain damage.
Administer medications and blood products as required per facility protocol
Medications may be given to manage symptoms of vomiting, diarrhea, fever, hyper- or hypoglycemia, seizures, swelling and pain.
Patients with liver involvement are at risk for bleeding due to effect on clotting factors. Blood products may transfused or plasma and platelets may be given to prevent bleeding.
Monitor diagnostic tests and labs
Watch for jaundice and elevation of liver enzymes and ammonia levels.
Provide postoperative and wound care as necessary
Patient may be required to undergo craniotomy to relieve intracranial pressure. Prevent infection at the incision site, which could lead to meningitis.
Provide communication, support and education for parents / caregivers
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