a simple guide for student nurses

1. H. Deepani
RN, BN, Nursing Tutor
School of Nursing
Colombo
Sri Lanka

2. Sudden alteration in normal brain
activity that cause distinct changes
in behavior and body function.

4. Petitmal/ minor /partial
Grandmal / major/ generalized
Status epilepticus

5. Brain injury
Brain tumors
Brain surgery
Cerebral infections –
meningitis/encephalitis
Drug toxicity- penicillin, theophylline
Hypoglycemia & hyperglycemia
hypoxia

6. Causes ctd…..
Hepatic coma
Pregnancy Induced Hypertension
High fever
Congenital diseases
Alcohol withdrawal

7. Onset /Aura
Tonic phase
Clonic phase
Post convulsive phase

9. Onset
 Aura
Tonic phase
 Rigidity of entire body
 Jerky muscle movement
 Epileptic cry due to contraction of diaphragm
 Tongue bite
 Excessive salivation
 Urinary & fecal incontinence
 unconscious

10. Clonic phase
Relaxation of all muscles
Deep coma
Noisy breathing
Post convulsive phase
Confused
Sleepy
c/o headache & muscle pain
Not aware about the attack

11. CLINICAL MANIFESTATION
Simple Partial Seizure
 Only finger or hand may shake
 Mouth may jerk uncontrollably
 May talk unintelligibly
 Dizzy
 May experience unusual sound or unpleasant sounds,
odor, or taste but without loss of consciousness

12. Simple Partial Seizure Manifestations

13. EEG
MRI scan
CT scan
Lumber puncture (CSF analysis)
Blood investigations (BU, SE, Blood
suger)

14. Pharmacological
surgical

15. Status epilepticus

16. A series generalized seizures that
occur without full recovery of
consciousness between attacks.
Considered a medical emergency.
Status Epilepticus Interfere with
respirations.

17. Ineffective airway clearance r/t
excessive production of secretion
Risk for injury r/t involuntary muscle
movement
Knowledge deficit r/t disease & its
control
Ineffective coping r/t stress imposed by
the disease
Fear r/t ever present possibility of
having seizure

18. To maintain airway patency
To prevent injury
To improve knowledge
To facilitate coping
To alleviate fear

19. First aid
Keep in lateral position- head turned to a
side (floor/ bed)
Remove equipment which may cause injury
from environment
Loosen cloth
Insert a tongue depressor if aura is
identified
Do not give anything by mouth
Do not try to stop muscle spasms force fully
Send to the hospital immediately
Keep in a bar bed
Inform Dr. immediately

20. Guidelines for Seizure Care

21. observation
Presence of aura
Duration (started time- time ended)
Type of muscle contractions
Respiratory status
Level of consciousness
Skin
Eyes
Presence of secretions
 presence of fecal & urinary
incontinence
Any injuries after seizure
Post-ictal behaviour

22. Other care
Give IV anti-epileptic drugs immediately
as ordered
O2 inhalation if cyanosis is present
Suck out secretions
Keep nil per oral
If febrile take measures to reduce fever
Check temperature 4 hourly
Observe client ½ hourly & maintain
records
Perineal care & loose dry cloth if
incontinent present
Give a drink after patient is fully
recovered

23. Continue anti-epileptic medications as
ordered
Diazepam ,phenobarbitone, paraldehyde
Health education
Keep the diagnosis card safe and with the
patient always
Continue medications
Keep medications under lock and key
Offer medication by a responsible person
Never leave client alone
Provide balanced diet
Do not give anything by mouth during
seizure

24. Take immediate measures to control
fever if there is a history of febrile fits
Follow clinics regularly
Complications of medications
Eg. Hypertrophy of gums, gums bleeding,
drowsyness, loss of apetite
Do not engage in harmful activities
Eg. Driving, machine operator, swimming,
work with fire, sand mining, climbing
trees
First aid for epilepsy

25. Questions ?

26. Thank you!