Question

D.F. is a 37-year-old woman who presents to the emergency department after having a seizure.

Subjective Data PMH: Seizures, unknown type Headache Housewife Feels weak No loss of consciousness Objective Data Vital signs: T 37 P 72 R 18 BP 114/64 Lungs: clear all bases O2 Sat = 100% CV = heart rate regular, positive peripheral pulses PERRLA What other questions should the nurse ask about the seizures? What other assessments are necessary for this patient? What are some of the causes of seizures? Develop a problem list from objective and subjective data. What should be included in the plan of care? What other risk factors are associated with this presentation? Based on the readings and the subjective and objective data, this patient most likely had what type of seizure? Summarize your answers in an APA formatted paper

Answer 1

PATIENT CAME TO THE HOSPITAL AFTER HAVING SEIZURES WITH PAST MEDICAL HISTORY OF SEIZURES, UNKNOWN HEADACHE, FEEL WEAK BUT NO LOSS OF CONSCIOUSNESS.

OBJECTIVE DATA:- VITALS ARE NORMAL i.e. T=37, P=72, R=18, B.P=114/64mmHg. LUNGS= CLEAR, O₂ SATURATION= 100%, CV= HEART RATE REGULAR, POSITIVE PERIPHERAL PULSES, PERRLA= PUPILS EQUALLY ROUND AND REACTIVE TO LIGHT AND ACCOMODATION.

SUBJECTIVE DATA:- NURSE SHOULD ASK THE FOLLOWING HISTORY FROM THE PATIENT AFTER SEIZURE:-

1. WAS THERE ANYTHING ABNORMAL OCCUR BEFORE SEIZURE?
2. WHAT IS THE ONSET AND DURATION OF THE SEIZURE?
3. IS THERE ANY AGGRAVATING FACTORS SUCH AS ANY STRESS, INJURY etc.
4. WHAT ARE THE ACTIVITIES OF THE APTIENT DURING THE SEIZURE SUCH AS IF THERE IS ANY KIND OF TREMBLING OF BODY PART, FALL ON GROUND, FROATHING IN MOUTH, CLENCHING OF TEETH, etc.
5. IS THERE ANY LOSS OF CONSCIOUSNESS OR AFTER SEIZURE IS THE PATIENT REMEMBER WHAT HAPPEN TO HER IN LAST FEW MINUTES OR HOURS?
6. IS THERE ANY PRODROMAL SIGN FOUND IN APTIENT SUCH AS MOOD CHANGES, IRRITABILITY, INSOMNIA.
7. IS THERE ANY LOSS OF MOTOR ACTIVITY OR BOWEL AND BLADDER FUNCTION.

ASSESMENT OF PATIENT AFTER SEIZURE:- NURSE MUST DO THE FOLLOWING ASSESSMENT TO THE PATIENT AFTER SEIZURE:-

• PHYSICAL AND NEUROLOGICAL EXAMINATION:- TO ASSESS ANY KIND OF INJURY TO THE HEAD, CHECK REFLEXES AND ANY ALTERATION IN THE CONSCIOUSNESS.
• DIAGNOSTIC EXAMINATION INCLUDE: BIOCHEMISTRY, HEMATOLOGICAL AND SEROLOGICAL STUDIES.
• RADIOLOGICAL EXAMINATION INCLUDING MRI, WHICH IS USED TO DETECT ANY LESION IN THE BRAIN, FOCAL ABNORMALITIES, CEREBROVASCULAR ABNORMALITIES AND CEREBRAL DEGENERATIVE CHANGES.
• EEG( ELECTROENCEPHALOGRAM):- HELPS IN IDENTIFYING THE DIFFERENT TYPES OF SEIZURES.
• SPECT(SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY):- USEFUL TO IDENTIFY THE EPILEPTOGENIC ZONE SO THAT THE AREA IN THE BRAIN GIVING RISE TO SEIZURES CAN BE REMOVED SURGICALLY.

CAUSES OF SEIZURES:- SOME OF THE CAUSES OFTHE SEIZURES ARE AS FOLLOWS:

• HEAD INJURY OR TRAUMA
• BRAIN TUMOR
• HYPERTHERMIA
• DRUG ABUSE OR DRUG WITHDRAWL
• MISSED ANTICONVULSIONS
• ELECTRIC SHOCK
• SLEEP DEPRIVATION
• ADVERSE EFFECT OF ANY MEDICATION
• ECLAMPSIA
• DOWN SYNDROME

PROBLEM LIST OF PATIENT:- 37 YEARS OLD PATIENT HAS FOLLOWING PROBLEMS:-

• SEIZURES
• UNKNNOWN HEADACHE
• FATIGUE( WEAKNESS)
• NO LOSS OF CONSCIOUSNESS

CARE PLAN OR MANAGEMENT OF PATIENT WITH SEIZURES:-

• NOTE THE TIME AND DATE OF THE SEIZURE.
• ASSESSS OR ASK IF THE CLIENT EXPERIENCE ANY AURA, ANY CHANGE IN THE FACIAL EXPRESSION, SOUND OR CRY OCCURED FROM CLIENT.
• ADMINSTER OXYGEN.
• IF THERE IS SECRETIONS OR FROATHING IN THE MOUTH DO SUCTONING.
• TRY TO FIND OUT THE REASON OF THE SEIZURE BY DIFFERENT DIAGNOSTIC METHODS.
• DONOT RESTRAIN THE CLIENT.
• ASSESS THE LEVEL OF CONSCIOUSNESS.
• MAKE SURE THE AIRWAY IS PATENT.
• LOOSEN THE CLOTHINNG.
• ADMINISTER I/V MEDICATION AS PRESCRIBED BY PHYSICIAN TO STOP SEIZURES.
• DOCUMENT THE HISTORY OF THE CLIENT.
• PROVIDE PRIVACY IF POSSIBLE.
• MONITOR THE BEHAVIOUR FOLLOWING THE SEIZURE SUCH AS MOTOR ABILITY AND SPEECH ABILITY.
• INSTRUCT THE CLIENT TO AVOID DRUG ABUSE, STRESS, FATIGUE AND STROBE LIGHTS.
• ENCOURAGE THE CLIENT TO CONTACT AVAILABLE COMMUNITY RESOURCES SUCH AS EPILEPSY FOUNDATION OF AMERICA.
• ENCOURAGE CLIENT TO WEAR MEDIC-ALERT BRACELET.

RISK FACTORS OF SEIZURES:- RISK FACTORS ARE THE FACTORS THAT INCREASES THE RISK OF DEVELOPING ANY DISEASE IN THE PERSON. SOME OF THE RISK FACTORS IN CASE OF SEIZURES ARE FOLLOWING:-

1. STROKE
2. EPILEPSY
3. LACK OF OXYGEN TO THE BRAIN
4. USE OF COCAINE
5. BLEEDING IN BRAIN
6. ABNORMAL BLOOD VESSELS IN BRAIN.
7. ALZHEIMER’s DISEASE
8. AUTISM SPECTRUM DISORDER
9. FEBRILE ILLNESS.
10. INFECTION TO BRAIN SUCH AS MENINGITIS, ENCEPHALITIS.

WHAT TYPE OF SEIZURE THE PATIENT HAD:-

FROM THE ABOVE GIVEN DATA THE PATIENT HAD SIMPLE PARTIAL SEIZURES, WHICH PRODUCES SENSORY SYMPTOMS ACCOMPANIED BY MOTOR SYMPTOMS THAT ARE LOCALIZED OR CONFINED TO A SPECIFIC AREA. THE CLIENT REMAINS CONSCIOUS AND MAY REPORT AURA, ALSO CLIENT EXPERIENCES HEADACHE AFTER AND BEFORE THE OCCURANCE OF THE SEIZURE.