status epileptic us power point 1232357142234770 3

8/8/2019 Status Epileptic Us Power Point 1232357142234770 3

1/22

STATUS

EPILEPTICUS


2/22

SEIZURESeizuressudden, excessive, disorderly electrical

discharges of the neurons.

EFFECTS OF SEIZURE: alteration inthe following

mental status LOC sensory and speciual senses motor funtion


3/22

TYPES OF SEIZURE

GRAND MAL

most common type of seizure

The phases are as follows:


4/22


5/22

PETIT MAL (Absence Seizure or Little Sickness)

o not preceeded by AURAo little or no toni-clonico charac blank facial expression, automatism like lip-chewing,

cheek smackingo regain of consciousness as rapid as it was lot for 10-20secso usually occurs during childhood and adolescence

JACKSONIAN / FOCAL SEIZUREo common for patients with organic brain lesion like frontal

lobe tumoro aura is present(numbness, tingling, crawling feeling)o charac by tonic-clonic movements of group muscle e.g.

Hands, foot, or face then it proceeds toi grand mal seizure

FEBRILE SEIZUREo this is common for children


6/22

STATUS EPILEPTICUS


7/22

STATUS EPILEPTICUS(ACUTE PROLONGED SEIZURE ACTIVITY)IS A SERIES OF GENERALIZED SEIZURE THAT OCCUR

WITHOUT FULL RECOVERY OF CONSCIOUSNESSBETWEEN ATTACKSTHE TERM HAS BEEN BROADENED TO INCLUDECONTINUOUS CLINICAL OR ELECTRICAL SEIZURESLASTING AT LEAST 30 MINUTES, EVEN WITHOUT

IMPAIRMENT OF CONSCIOUSNESS.A seizure is a sudden disruption of the brain's normal electricalactivity, which can cause a loss of consciousness and make thebody twitch and jerk. This condition is a medical emergency.


8/22

CAUSES

not taking anticonvulsant medication

also caused by an underlying condition, such

as meningitis, sepsis, encephalitis, braintumor, head trauma, extremely high fever, low

glucose levels, or exposure to toxins.


9/22

SYMPTOMS

The characteristic symptom of status epilepticus is seizuresoccurring so frequently that they appear to be one continuous seizure.These seizures include severe muscle contractions and difficulty

breathing. Permanent damage can occur to the brain and heart iftreatment is not immediate. A person's symptoms can range from simplyappearing dazed to the more serious muscle contractions, spasms, andloss of consciousness. The specific symptoms depend on the underlying

type of seizure.


10/22

TWO CATEGORIES OF STATUS EPILEPTICUS

CONVULSIVE

Epilepsia partialis continua is a variant it involve an hour, day or

even week-long jerking. It is a consequence of vascular disease,

tumor or encepalitis and drug resistant.

NONCONVULSIVE

Complex Partial Status Epilepticus CPSE and absence status

epilepticus are rare forms of the condition which are marked by

nonconvulsive seizures. In the case of CPSE, the seizure is confined

to a small area of the brain, normally the temporal lobe. But thelatter, absence status epilepticus, is marked by a generalised seizure

affecting the whole brain, and an EEG is needed to differentiate

between the two conditions. This results in episodes characterized

by a long-lasting stupor, staring and unresponsiveness.


11/22

HOW IT IS DIAGNOSED?

Status epilepticus is diagnosed according to its characteristicssymptoms. The doctor will order test to look for the cause of theseizures. This may include

blood test

ECG to check for an abnormal heart rhythm

EEG to check electrical activity in the brain

MRI or CT scan to check forbraing tumord orsigns of damage to the brain tissue.


12/22

Nursing DiagnosisHigh Risk for Injury r/t Seizure

Activity

Individual Coping r/t perceivesocial stigma, potential changesin employment


13/22

MEDICATIONS diazepam (Valium)

this will stop motor movement

Phenytoin (Dilatin)

Phenobarbital (Barbita)

Paraldehyde

Thiopentahl sodium (Pentotal sodium)

General anesthesia may also be used as a treatment of last

resort to stop seizure activity


14/22

NURSING INTERVENTIONPREVENTING INJURY

IMPROVING COPING MECHANISMS

PROVIDING PATIENT AND FAMILY EDUCATION

MONITORING AND MANAGING POTENTIAL COMPLICATIONS

TEACHING PATIENTS SELF-CARE

REDUCING FEARS OF SEIZURE


15/22

PREVENTING INJURY

injury prevention for the patient with seizure is a PRIORITY.

patient should be placed on the floor and remove any

obstructive items patient should never be forced into a position

pad side rails

do not attempt to pry open jaws that are clenched in a spasm

to insert anything.

if possible place the patient on one side with head flexed

forward,

back


16/22

PATIENT EDUCACTION

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


17/22

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 ensurethe adequacy of the treatment regimen and

to prevent the side effects.

back


18/22

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.

back


19/22

PROVIDING PATIENT AND

FAMILY EDUCATIONOngoing education and encouragement

should be given to patients to enable them

to overcome these feelings. The patient and

family should be educated about themedications as well as care during a seizure.

back

perhaps the most valuable facets are

education and efforts to modify the

attitudes of the patient and family toward

the disorder.


20/22

MONITORING AND MANAGING

POTENTIAL COMPLICATIONS

back

Patients should have plan to have

serum drug levels drawn at regular

intervals. The patient and familyare instructed about the side effects

and are given specific guidelines to

assess and report signs andsymptoms indicating medication

overdose.


21/22

TEACHING PATIENTS SELF

CARE

back

Like thorough oral hygiene after eachmeal, gum massage, daily flossing, and

regular dental careThe patient is also instructed toinform all health care providers of the

medication being taken because of

the possibility of drug interactions. Anindividualized comprehensive

teaching plan is needed to assist the

patient and family to adjust to this

chronic disorder.


22/22

thank you and God Bless UsAlways

Presented by: Dave Jay S.

Manriquez RN.

status epileptic us power point 1232357142234770 3

Documents