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Epilepsy

Epilepsy. Difference Between Seizure and epilepsy. A seizure is a brief, temporary disturbance in the electrical activity of the brain Epilepsy is a disorder characterized by recurring seizures (also known as “seizure disorder”). Key Fctors.

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Epilepsy

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  1. Epilepsy

  2. Difference Between Seizure and epilepsy • A seizure is a brief, temporary disturbance in the electrical activity of the brain • Epilepsy is a disorder characterized by recurring seizures (also known as “seizure disorder”)

  3. Key Fctors • Seizures are abrupt, uncontrolled electrical brain discharges that cause alterations in level of consciousness and changes in motor and sensory behavior. • Epilepsy can be idiopathic ) 70 %) or secondary (30%) • It is not associated with alterations in intellectual capabilities. • Seizures are classified as neurologic emergencies. • Sustained untreated seizures can result in hypoxia, cardiac dysrhythmias, and lactic acidosis.

  4. A seizure may appear as: A sudden cry and fall, followed by • Convulsive movements of all limbs • Shallow/interrupted breathing - cyanosis • Loss of bowel/bladder control • Slow return to consciousness, post-seizure confusion and/or fatigue

  5. Risk Factors • Genetic predisposition • Acute febrile state/ febrile convulsion in kids • Head trauma • Cerebral edema • Abrupt cessation of antiepileptic drugs (AEDs) • Infection; meningitis • Metabolic disorder (for example, hypoglycemia) • Exposure to toxins • Brain tumor, CVA • Hypoxia • Acute drug and alcohol withdrawal • Fluid and electrolyte imbalances • Complication of diabetes or pregnancy

  6. Triggering factors • Increased physical activity. • Stress, illness • Reading • Fatigue. • Alcohol, and Caffeine. • Flash light, lack of Sleep • Some chemicals, dehydration • Sun light & Hot water Menstruation

  7. Types of epilepsy • 1. Generalized; involve the whole brain & loss of consciousness • Partial; involve part of the brain, may / may not involve loss of consciousness

  8. Diagnostic Procedures and Nursing Interventions • Electroencephalogram (EEG) • Blood and urine tests, • magnetic resonance imaging (MRI), • computed tomography imaging (CT), • positron emission tomography (PET) scan, • cerebrospinal fluid (CSF) analysis, • skull x-ray, • Electrolyte profile and drug screen

  9. Assess/Monitor • Airway patency • Aspiration • Injury post seizure • If client experienced an aura (warning sensation); possible indication of the origin of seizure • Possible trigger factors (for example, fatigue)

  10. NANDA Nursing Diagnoses • Risk for injury • Risk for impaired spontaneous ventilation • Risk for ineffective tissue perfusion (cerebral)

  11. Treatment Goals in Epilepsy • Help person with epilepsy lead full and productive life • Eliminate seizures without producing side effects • Tailor treatment to needs of individuals/special populations :Women, Children, Elderly, Hepatic or renal failure and other diseases

  12. Nursing Interventions • Protect the client from injury . • Maintain a patent airway. • Be prepared to suction. • Turn the client to the side (??). • Loosen clothing. • Do not attempt to restrain the client.

  13. Nursing Interventions • Do not attempt to open jaw during seizure activity . Do not use padded tongue blades. • Administer oxygen as prescribed. • Administer prescribed medications • Document onset and duration of seizure and client findings/ observations prior to during, and following the seizure (level of consciousness, apnea, cyanosis, motor activity, incontinence).

  14. Post Seizure • Maintain the client in a side-lying position to prevent aspiration and tofacilitate drainage of oral secretions. • Check vital signs. • Perform neurological checks. • Reorient and calm the client • Institute seizure precautions. • Provide client education regarding seizure management: • The importance of monitoring AED levels and maintaining therapeutic medication levels. • Possible drug interactions (for example, decreased effectiveness of oral contraceptives). • Encourage the client to wear a medical alert bracelet (necklace) at all times.

  15. Seizure Precautions • Standby oxygen, airway, and suctioning equipment • IV access (medication administration during seizure) • Side rails in up position and bed in lowest position

  16. Potentially Dangerous Responses to Seizure • Don’t restrain person • Don’t put anything in the person’s mouth • Don’t try to hold down or restrain the person • Don’t attempt to give oral antiseizure medication • Don’t keep the person on their back face up

  17. Complications and Nursing Implications • Aspiration • Turn the client to side, suction as needed. • Status Epilepticus • Establish airway, • provide oxygen, • ensure IV access, • perform EKG monitoring,and • monitor ABG results. • As prescribed, administer diazepam (Valium) or and a by a continuous infusion of phenytoin (Dilantin).

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