Diagnostics: Status Epilepticus
Diagnostics: Status Epilepticus
DIAGNOSTICS 1. CT-SCAN brain lesion d/t head trauma 2. EEG hyperactivity of brain waves (all elevated) Alpha, beta, delta, theta waves
PREDISPOSING FACTORS 1. Head injury secondary to birth trauma 2. Lead poisoning 3. Genetics 4. Brain tumor 5. Nutritional and metabolic deficiencies 6. Sudden withdrawal of anti-convulsive drugs Causes STATUS EPILEPTICUS DOC: Diazepam, Glucose 7. Physical and emotional stress
1. Maintain patent airway and promote safety before seizure activity Clear the site of sharps, harmful objects Loosen clothing of the patient Avoid use of restraints fractures Maintain side rails Turn head to side to prevent aspiration Tongue guard is between mouth and teeth to prevent biting of the tongue 2. Avoid precipitating stimulus Bright/glaring lights Noise
TYPES OF SEIZURES 1. Generalized Grand Mal (Tonic-Clonic) With or without an aura Epigastric pain initial sign of an aura (aura is an initial sign of seizures) Visual auditory olfactory tactile sensory experience Epileptic cry Fall Loss of consciousness for 3-5 minutes Tonic-clonic contractions Direct symmetrical extension of extremities Shaking/convulsive activity Post-ictal sleep (unresponsive sleep) Petit Mal (Absence Seizure) S/sx: Blank stare Decreased blinking of the eyes Twitching of the mouth and loss of consciousness for 5-10 seconds 2. Partial Seizures Jacksonian seizure (focal seizures) characterized by tingling and jerky movements of index finger and thumb spreads to shoulders Psychomotor seizure (focal-motor seizures) characterized by: Automatism stereotype, non-repetitive and nonpurposive behavior Clouding of consciousness not in contact with reality Mild hallucinating sensory experience 3. Status Epilepticus continuous uninterrupted seizure activity that if left untreated may lead to hyperpyrexia coma death Increased electrical activity in brain increased metabolism increased glucose and oxygen use, increased temperature coma death DOC: Valium, Glucose
4. Institute seizure and safety precautions Post-seizure: O2 inhalation Suction apparatus For a one year old client suffering grand mal seizures: NOT MouthpieceEh onte lang teeth ng one year old eh Give pillows support for the head (For banging of head during seizure activity)
3. Administer medications as ordered Phenytoin (Dilantin) Gingival Hyperplasia Use soft-bristled toothbrush Ataxia Nystagmus Hirsutism Diazepam (Valium) for status epilepticus Carbamazepine (Tegretol) Also used for Trigeminal neuralgia (Tic Dolor) Phenobarbitals (Luminal)
5. Monitor and document the following Onset and duration Type of seizure Duration of post-ictal sleep increased length of sleep can lead to status epilepticus