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

seizures are episodes of abnormal motor, sensory, autonomic or psychic activity or a combination of these, that result from sudden excessive discharge from cerebral neurons.There are of two types: partial seizures that begin in one part of the brain and generalised seizures that involve electrical discharges in the whole brain. In simple partial seizures consciousness remains intact, whereas in a complex partial seizure consciousness is impaired.

1.

according to the nature of the seizure, treatment can be decided. so documentation of correct data is necessary.

since the type of seizure is unknown in the patient, it is important to diagnose before the beginning of treatment.

• the circumstances before the seizure( visual, auditory and olfactory stimuli; tactile stimuli; emotional or psychological disturbances; sleep; hyperventilation.
• the occurrence of an aura (a premonitory warning sensation, which can be visual, auditory, or olfactory)
• the first thing the patient does in the seizure - where the movements or stiffness begins, conjugate gaze position, and the position of the head at the beginning of the seizure.
• the type of movements in the part of the body involved.
• the area of the body involved (turn back the bedding to expose patient)
• whether the eye or head turned to one side.
• the presence or absence of automatisms(involuntary motor activity, such as lip smacking or repeated swallowing).
• incontinence of urine or stool.
• duration of each phase of the seizure.
• any obvious paralysis or weakness of arms or legs after the seizure.
• inability to speak after the seizure.
• movements at the end of the seizure.
• whether or not the patient sleep afterwards.
• cognitive status ( confused or not confused) after the seizure.

2.

document events leading to and occurred during and after the seizure and to prevent complications (aspiration, injury).The patient is at risk for hypoxia, vomiting and pulmonary aspiration.check for the predisposing factors.

3.

causes of seizure

The underlying cause of the seizure is an electrical disturbance in the nerve cells in one section of the brain; these cells emit abnormal, recurring, uncontrolled electrical discharges

there are two causes idiopathic and acquired

idiopathic

• genetic
• developmental defects

acquired

• cerebrovascular disease
• hypoxemia
• fever (paediatric)
• head injury
• hypertension
• central nervous system infections
• metabolic and toxic conditions
• brain tumour
• drug and alcohol withdrawal
• allergies