Tuesday, October 20, 2009

Nursing Care Plans for Epilepsy

. Tuesday, October 20, 2009

Epilepsy is a paroxysmal neurological disorder; epilepsy is a condition of the brain characterized by a susceptibility to recurrent seizures. It's also known as seizure disorder. Seizures are paroxysmal events associated with abnormal electrical discharges of neurons in the brain. In most patients, this condition doesn't affect intelligence. Epilepsy characterized by recurrent episodes of convulsive movements or other motor activity, loss of consciousness, sensory disturbances, and other behavioral abnormalities. Epilepsy often considered a syndrome rather than a disease, because epilepsy occurs in more than 50 diseases. Epilepsy usually occurs in patients younger than age 20, patients with Epilepsy achieve good seizure control with strict adherence to prescribed treatment.

Causes for Epilepsy
About half the cases of epilepsy are idiopathic. Nonidiopathic epilepsy may be caused by:

  • Primary central nervous system CNS disorders include any potential mass effect (tumor, abscess, atrioventricular malformation AVM, aneurysm, or hematoma)
  • Stroke (especially those that are embolic.).
  • Genetic abnormalities (E.g. Tuberous sclerosis and phenylketonuria PKU)
  • Prenatal injuries
  • Metabolic abnormalities, such as hypocalcemia, hypoglycemia, and pyridoxine deficiency
  • Brain tumors
  • Infections, such as meningitis, encephalitis, or brain abscess
  • Developmental disorders. Epilepsy can be associated with other developmental disorders, such as autism and Down syndrome
  • Traumatic injury, especially if the dura mater was penetrated
  • Toxins, such as mercury, lead, or carbon monoxide
Epilepsy occurs in all races and ethnicities, Researchers have also detected hereditary EEG abnormalities in some families, and certain seizure disorders appear to have a familial incidence. Different age groups have distinct associated causes. newborns up until 6 months of age, seizures are generally caused by birth trauma or metabolic disturbances. In children from 6 months to 5 years of age, etiology is related to febrile episodes or metabolic disturbances (hyponatremia, hypernatremia, hypoglycemia, hypocalcemia). In the 5- to 20-year-old group, seizures are primarily idiopathic (50%). In adults from 20 to 50 years of age, a new onset of seizures is almost exclusively caused by trauma or tumors. In older adults, seizures are generally caused by vascular disease cardiac dysrhythmias and Dementia.

Complications for Epilepsy
Associated complications can occur during a seizure:
  • Anoxia from airway occlusion by the tongue or vomitus and
  • Traumatic injury could result from a fall while the patient is confused or has an altered level of consciousness.
  • Drowning
 Other life threatening complications
  • Sudden unexplained death
  • Status epilepticus

Nursing Assessment Nursing Care Plans for Epilepsy
Signs and symptoms vary Depending on the type and cause of the seizure. Physical findings may be normal if the assessment is performed when the patient isn't having a seizure. If the seizure is associated by a brain tumor, which may reveal signs and symptoms of that problem
Patient’s history of seizure occurrence

Diagnostic tests for Epilepsy
  • Electroencephalogram EEG
  • Computed tomography scanning
  • magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Other helpful tests include serum glucose and calcium studies, skull X-rays, lumbar puncture, brain scan, and cerebral angiography, Neuropsychological tests.

Treatment for Epilepsy
Specific to the type of seizure.
  • commonly prescribed drugs include phenytoin, carbamazepine, phenobarbital, valproic acid, and primidone administered individually for generalized tonic-clonic seizures and complex partial seizures. Valproic acid, clonazepam, and ethosuximide are commonly prescribed for absence (petit mal) seizures. Lamotrigine is also prescribed as adjunct therapy for partial seizures. Fosphenytoin is an I.V. preparation that's effective in treatment.
  • Surgical removal of a demonstrated focal lesion to attempt to end seizures
  • Vagal nerve stimulation
  • Transcranial magnetic stimulators

Nursing diagnosis Nursing Care Plans for Epilepsy
  • Ineffective airway clearance related to clonic tonic motor activity and tongue obstruction
  • Anxiety
  • Deficient knowledge (diagnosis and treatment)
  • Fear
  • Ineffective coping
  • Risk for injury
  • Social isolation

Nursing Key outcomes, nursing interventions and Patient teaching Nursing Care Plans for Epilepsy


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