Presentation Transcript
Chapter 61 Management of Patients With Neurologic Dysfunction :Chapter 61 Management of Patients With Neurologic Dysfunction
Seizures :Seizures Abnormal episodes of motor, sensory, autonomic, or psychic activity (or a combination of these) resulting from a sudden, abnormal, uncontrolled electrical discharge from cerebral neurons
Classification of seizures: see Chart 61-3
Partial seizures: begin in one part of the brain
Simple partial: consciousness remains intact
Complex partial: impairment of consciousness
Generalized seizures: involve the whole brain
Algorithm for Classification of Seizures :Algorithm for Classification of Seizures
Specific Causes of Seizures :Specific Causes of Seizures Cerebrovascular disease
Hypoxemia
Fever (childhood)
Head injury
Hypertension
Central nervous system infections
Metabolic and toxic conditions
Brain tumor
Drug and alcohol withdrawal
Allergies
Nursing Care-Seizures :Nursing Care-Seizures Protect
Lower to floor; pad side rails; pillow under head; don’t restrain
No bite block; no tongue blade
Allow post-ictal rest
Maintain airway (prevent aspiration)
Turn on side; loosen clothing around neck
Document
Onset; duration
Nature of activity; presence of autonomic signs
Post-ictal state
Nursing Care-Seizures :Nursing Care-Seizures After seizure care
Keep patient side-lying to prevent aspiration
If patient is confused after seizure, reoriented upon awakening
If agitated after seizure, use calm persuasion and gentle restraint
Seizure Medications :Seizure Medications Dilantin (Phenytoin)
Phenobarbital
Valium (Diazepam)
Depakene (Valporic acid)
Klonopin
Neurontin
Cerebyx
Keppra
Tegretol (carbamazepine)
Depakote 7
When taking anticonvulsants: :When taking anticonvulsants: Take daily dose to keep blood levels constant
Have serum drug levels drawn before daily dose
Avoid abrupt discontinuation of medications
Avoid alcohol
Consult physician before taking over-the-counter medications
Avoid activities in which alertness and coordination are required until effects of medicine is known
Wear medical alert bracelet
Good oral hygiene 8
Seizure Complications :Seizure Complications Status epilepticus
A state of constant seizure or condition when seizures recur in rapid succession without return to consciousness between seizures.
Neurologic emergency
Can involve any type of seizure
It causes the brain to use more energy than supplied
Neurons become exhausted and cease to function
Permanent brain damage can result 9