Seizure: Status Epilepticus, a comprehensive pdf file by Dave Manriquez

1. Dave Jay S. Manriquez RN. Submitted to: Mrs Norma Hinoguin
Adult Health Nursing Phase 1 6-9pm Tuesday
SEIZURE
 sudden, excessive, disorderly electrical discharges of the neurons.
EFFECTS OF SEIZURE: alteration in the following
 mental status
 LOC
 sensory and special senses
 motor funtion
CLASSIFICATION OF SEIZURES
A. Primary Generalized Seizure
B. Partial Seizure
GENERALIZED SEIZURES:
GRAND MAL (Tonic-Clonic)
 most common type of seizure
PETIT MAL (Absence Seizure or Little Sickness)
 not preceeded by AURA
 little or no toni-clonic
 charac blank facial expression, automatism like lip-chewing, cheek
smacking
 regain of consciousness as rapid as it was lot for 10-20secs
 usually occurs during childhood and adolescence
JACKSONIAN / FOCAL SEIZURE
 common for patients with organic brain lesion like frontal lobe tumor
 aura is present(numbness, tingling, crawling feeling)
 charac by tonic-clonic movements of group muscle e.g. hands, foot, or face then
it proceeds toi grand mal seizure
FEBRILE SEIZURE
 this is common for children <5yo, when temp. is rising
PSYCHOMOTOR SEIZURE
 aura is present (hallucinations or illusion)
 charac by mental clouding (being out of touch with the envt)
 appears intoxicated
 the client may commit violent or antisocial acts, e.g. Going naked public, running
PARTIAL SEIZURE
2 TYPES OF PARTIAL SEIZURES:
A. Simple Partial Seizure
B. Complex Partial Seizure
 Simple Partial Seizure

2.  Awareness Preserved
 Memory Preserved
 Consciousness Preserved
 Complex Partial Seizure
 Awareness Preserved
 Memory Preserved
 Consciousness Preserved
CAUSES OF SEIZURES IN CHILDREN
• Birth Traumas
• Infections – Meningitis
• Congenital Abnormalities
• High Fever
CAUSES OF SEIZURES IN MIDDLE YEARS
• Head Injuries
• Infections
• Alcohol
• Stimulant Drugs
• Medications its Side Effects
CAUSES OF SEIZURES IN THE ELDERLY
• Brain Tumors
• Strokes
CHEMICAL IMBALANCES CAUSE SEIZURE
• Alcohol
• Cocaine
• Other Drugs
• Low blood sugar, low oxygen, low blood sodium, low calcium, kidney and renal
failure
Nursing Management During a Seizure
- The nursing goal is to prevent injury to the patient. This includes not only
physical support but psychological support as well.
 Provide privacy
 Ease the patient on the floor, if possible
 Protect the head with a pad to prevent injury
 Loosen constrictive clothing
 If aura precedes the seizure, place a padded tongue blade between the teeth
 Do not attempt to pry open jaws that are clenched in a spasm to insert anything
 No attempt should be made to restrain the patient during the seizure
 Place the patient on one side with head flexed forward

3.  The patent should be reoriented to the environments and happening upon
awakening
Nursing Assessment during a Seizure
- Observe and to record the sequence of symptoms.
1. Description of the circumstances before the attack.
2. The first thing a patient does in an attack.
3. The type of movements in the part of the body involved.
4. The size of both pupils.
5. Whether or not there is automatisms
6. Duration of each phase of the attack
7. Unconsciousness, ability to speak, consciousness
Epilepsy
 Disorders of brain function characterized by recurring seizures.
 Disturbance in consciousness, movement, behavior, mood, sensation, perception.
It is not a disease but a symptom.
 Electrical disturbance in one section of nerve cells causing uncontrolled electrical
discharges.
How is Epilepsy Diagnosed?
 History
 Physical Exam
 Electroencephalogram
 MRI (Neuro-imaging)
 CT Scan
6 Truths about Epilepsy
1. Not to be called epileptic but a person with a seizure disorders
2. In epilepsy there might be seldom brain damage, brain function is disturb by
seizure
3. Difference level of Intelligence
4. Violence does not follow epilepsy
5. Non usually inherited – cause is unknown and usually associated with
environmental causes
6. Epilepsy is not a curse is a medical condition
Nursing Diagnoses
• Fear related to the ever-present possibility of having seizures
• Ineffective coping related to stresses imposed by epilepsy
• Knowledge deficit about epilepsy and its control
• High risk for injury during seizures
Goals:
Short Term Goals:
• Maintenance of control of seizures
• Achievement of a satisfactory psychosocial adjustment
• Acquisition of knowledge and understanding about the condition
Long Term Goals:
• To achieve a satisfactory life adjustment
• To prevent or manage episodes of status epilepticus

4. Nursing Interventions:
• Seizure Control
• Improved Coping Mechanisms
• Patient Education
STATUS EPILEPTICUS
PATIENT EDUCATION
 TAKE MEDICATION AT REGULAR BASIS
 AVOID ALCOHOL. Lowers seizure threshold
 ADEQUATE REST
 WELL-BALANCED DIET
 AVOID DRIVING, OPERATING MACHINES, SWIMMING UNTIL
SEIZURES ARE WELL CONTROLLED.
 LIVE AN ACTIVE LIFE
REDUCING FEARS OF SEIZURE
 Fear that a seizure may occur unexpectedly can be reduced by the patients
adherence to the prescribed treatment regimen. Cooperation of the patient and
family and their trust in the prescribed regimen are essential for control of
seizures.
 Periodic monitoring is necessary to ensure the adequacy of the treatment regimen
and to prevent the side effects..
IMPROVING COPING MECHANISMS
 It has been noted that the social, psychological, and behavioral problems
frequently accompanying the attack can be more handicap than the actual seizure.
 Counselling assists the individual and family to understand the condition and the
limitations imposed by it. Social and recreational opportunities are good for
mental health . Nurses can improve the quality of life for patients with the
disorder by educating them and their family about the symptom and also the
management.
PROVIDING PATIENT AND FAMILY EDUCATION
 Ongoing education and encouragement should be given to patients to enable
them to overcome these feelings. The patient and family should be educated about
the medications as well as care during a seizure.
 Perhaps the most valuable facets are education and efforts to modify the attitudes
of the patient and family toward the disorder.