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    BANGNAM
    2023-02-16 11:50:52
    5 min read
    · 5:30

    What are the nursing goals for a child with seizure disorder?

    Introduction

    A seizure is a type of disorder characterized by a sudden, short-term disturbance of the brain activity involving involuntary changes in sensation, behavior, consciousness, or motor function. This article is about the nursing diagnosis and
    care plan for seizures and is meant as a guide to nursing students.

    Show

    When determining a patient’s needs regarding nursing strategy, it is important to know that:

    The onset of this disorder can be either sudden or gradual. Sudden onset usually involves intense involuntary motor
    activity, such as abdominal and chest muscle contractions or jerking of the limbs. The patient may have a loss of bowel and bladder control during a seizure.

    Seizures are often characterized by a blank stare, called an “ictal phase.” Afterward, there is usually confusion and lack of memory, called an “interictal period.”

    A seizure is described as generalized or partial. A generalized seizure affects both sides of the brain; a partial seizure involves only one side.

    There are
    three classifications of seizures:

    As you read on, keep in mind that our top writers are ready to help in case you get stuck or cannot complete your nursing assignment due to other reasons such as a busy schedule. All you need to do is
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    Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students, for learning purposes only, and should notbe applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

    Nursing Assessment for Seizures

    – Numbness or tingling in an arm or leg

    – Jerking movements of the arms or legs

    – Sudden loss of consciousness, “blackout.”

    – Oxygen deprivation due to
    breathing problems resulting from muscle spasms. Some people may have convulsions so strong that they break bones, especially of the spine.

    – Brain injury from
    falls

    -Physical stress and
    sleep deprivation

    -Alcohol withdrawal

    -Concussions and traumatic brain injuries are caused by accidents or explosions.

    The disorder’s onset is often sudden and may involve intense involuntary
    motor activity, such as abdominal or chest muscle contractions or jerking of the limbs.

    -The patient may have a loss of bowel and bladder control during a seizure.

    Risk factors may include

    Nursing care plan goals:

    Use the following nursing interventions as indicated:

    Rationale: IV fluids may be given either on an intermittent or continuous basis, depending on the type of seizure activity and severity of dehydration.

    Rationale: Helps to prevent fluid volume deficit or excess resulting from seizure activity (e.g., excessive salivation, perspiration, urinary output).

    Rationale: Helps to prevent medication errors resulting from misinterpretation of symptoms and side effects (e.g., postictal drowsiness or confusion mistaken for hypoxia) and provides a record for the client to review.

    Risk factors may include

    Nursing care plan goals:

    Use the following nursing interventions as indicated.

    Rationale: Helps to prevent further injury resulting from a seizure during the activity (e.g., the client could fall, hit self, or hurt others).

    Rationale: Rest helps to increase alertness and mental clarity.

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    Rationale: Carefully planning activities help to prevent injury to the self or others (e.g., automobile accidents, machinery mishaps).

    Rationale: Follows physician’s orders, maintains or improves
    activity level, and prevents injury to the self or others.

    Rationale:
    Activities that require less energy are more easily accomplished by weak clients.

    Rationale: Carefully planned activities help to prevent further injury from a seizure during the activity (e.g., the client could fall, hit self, or hurt others).

    Nursing diagnosis 3: Low self-esteem.

    Risk factors may include

    Nursing care goals:

    Use the following nursing
    interventions as indicated:

    Identify resources for information and support about epilepsy (e.g., self-help groups, websites).

    Support activities that help to restore self-worth.

    Carefully plan
    for first seizure activity after discharge from the hospital (e.g., driving) if appropriate; obtain necessary special equipment or instruction for safe use of equipment.

    Activity intolerance related to seizure activity: Avoid situations that increase seizures (i.e., precipitating events) and limit activities that are implicated in seizures.

    Carefully plan driving activity as prescribed by a physician; use support person or special equipment (e.g., automatic transmission, antiepileptic medications) to help prevent car accidents.

    Follow physician’s orders for
    activity level as prescribed; avoid strenuous activities that could cause a seizure.

    Nursing diagnosis 4: Blocked airway/ compromised breathing pattern.

    Risk factors may include:

    Nursing care goals:

    Use the following nursing interventions as indicated:

    Protect client’s airway (e.g., suction if obstructive mucus) during activity and at risk times for seizures when sedation is not used.

    Provide adequate lighting, assistance with mobility (e.g., handrails), and appropriate positioning of equipment to ensure safe activities.

    Assess client’s tolerance for activity and current limitations; avoid activity if it causes pain or fatigue, exacerbates symptoms (e.g., seizures), or causes decubitus ulcer formation.

    Minimize discomfort by ensuring that oral care is provided; apply appropriate nonirritating mouth rinses, lubricants, toothpaste, and dental appliances.

    Use appropriate positioning to
    prevent airway obstruction (i.e., head tilt or elevation) during or after seizure activity as prescribed by the physician; help the client assume or maintain a position that improves airway
    patency (e.g., sitting, prone).

    Use special positioning and handling techniques as prescribed by the healthcare provider to maintain the
    client’s safety if seizures and postictal states occur frequently.

    Nursing Diagnosis 5: Trauma/ risk for suffocation.

    Risk factors include:

    Nursing care goals:

    Use the following nursing interventions as indicated:

    Position client to prevent head/facial
    injuries (e.g., padded sides of the bed, soft pillow).

    Relieve excessive salivations by keeping your mouth slightly open (e.g., during sleep); consider installing suction devices in the home environment.

    Use special positioning and handling techniques as the healthcare provider prescribes to prevent trauma (e.g., airway obstruction, incontinence) if seizures and postictal states occur frequently.

    Nursing Diagnosis 6: Knowledge deficit.

    Risk factors include:

    Nursing care goals:

    Use the following nursing
    interventions as indicated:

    Administer medications according to physician orders; provide education about appropriate administration (e.g., with food, if possible).

    Provide education about the nature and course of epilepsy.

    Encourage the client to monitor themselves for seizure triggers (e.g., stress,
    missing meals).

    Teach family/significant others about medications and their side effects; provide information about equipment maintenance in the home environment.

    Provide information about epilepsy for schools, employers, and other settings outside the home to which the client will be exposed (e.g., community groups).

    Nursing diagnosis 7: Anxiety/fear.

    Risk factors include:

    Nursing care goal: Reduce the anxiety/fear
    related to epilepsy.

    Use the following nursing interventions as indicated:

    Prepare client and family for what to expect during and after seizures.

    Reassure the client that seizures
    are not a sign of impending death.

    Teach relaxation techniques (e.g., deep
    breathing, guided imagery).

    Provide opportunities for the client to contact others who are knowledgeable about epilepsy.

    Plan activities that will help keep the client busy and focused on valued life tasks.

    Seizure triggers (e.g., stress).

    The following interventions may help manage the crisis related to the impact of epilepsy on family functioning. The interventions are listed in order of priority, from those that should be implemented first to those that may be helpful when the immediate crisis has been resolved:

    Reassure client and family that seizures are not a sign of impending death.

    Reassure client and family that the seizures will not cause permanent brain damage.

    Help the client identify areas in which emotional support from family members would be helpful (e.g., help with driving when the client is on medication).

    Encourage the client to go out in public as much as possible (e.g., to work, school, church, shopping) despite fears about having a seizure in crowds; have family members talk this over with the client.

    Help the client maintain contact with other individuals with epilepsy (e.g., support group).

    Encourage family members to do the following:

    Occasionally attend support group
    meetings.

    Discuss feelings with other family members so that these feelings can be shared and understood by other important people in their lives.

    Provide a balanced discussion of any triggers that the client has identified (e.g.,
    stress).

    Risk factors may include

    The following interventions may be useful in managing the nonadherence related to medication side effects. The interventions are listed in order
    of priority, from those that should be implemented first to those that may be helpful when the immediate crisis has been resolved:

    Help the client feel empowered by educating them about all possible side effects of anticonvulsant medications.

    Help client and family understand that side effects are not uncommon and vary from individual to individual.

    Facilitate
    discussion of medication side effects; encourage the client to discuss concerns about side effects with a physician.

    Help the client initiate discussions with a physician regarding medication side effects (e.g., have family members help talk this over with the client).

    Help the client and family identify ways other than noncompliance to cope with side effects (e.g., distraction).

    Risk factors may include

    The
    following interventions may help manage the disturbing personal identity related to an epileptic seizure disorder:

    Help the client develop a realistic positive belief about their ability to function and accurately assess future capabilities.

    Encourage the client to develop a personal seizure action plan.

    Realize that each seizure is stressful for the client and family members; encourage them to talk about their feelings about what they have experienced.

    Identify support groups for people with epilepsy that may be available in your community.

    Treatment for Seizure Dependent Epilepsy

    Despite many years of research, there is currently no cure for epilepsy. However, medications are available to control seizures in about 70% of adults and 50% of children.

    The long-term goal in managing a seizure disorder is to
    reduce the frequency and severity of seizures while maximizing the number of days between seizures and minimizing the adverse long-term side effects of treatment.

    The first action after a seizure is to ensure that the cause has been identified, as described earlier.

    Medical management of seizure

    Medical management of seizure disorders consists of controlling the seizures through medication.

    The medical approach to seizure management is based on identifying an
    underlying cause for the seizures and then using medications targeted at that individual cause.

    Medical management includes a combination of both drugs and lifestyle adjustments, such as diet control, sleep hygiene, stress reduction techniques, homeopathicatural remedies, and other alternative treatments.

    The nurse’s role in seizure management is to educate the client on how to safely manage a seizure at home and assist with medication adjustments when appropriate.

    There are
    several categories of medications used to manage seizures: anticonvulsants, sedatives/hypnotics (used as an adjunct therapy), other antiepileptic medications, and antimicrobials.

    Antiepileptic medications are used to control seizures and are effective in about 70% of adults and 50% of children.

    Anticonvulsants (also called antiepileptic drugs or AEDs) are the primary medications used for seizure management. They include carbamazepine, clonazepam, divalproex sodium, ethosuximide,
    lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin sodium, primidone (also called valproic acid), topiramate, and zonisamide.

    Antimicrobials are used for seizure management in persons with a bacterial infection, such as meningitis. They include cefotaxime sodium, ceftriaxone sodium, and tobramycin sulphate.

    A sedative/hypnotic is an adjunctive therapy that can be used if seizures cannot be controlled by AEDs alone. These medications include clonazepam, lorazepam and
    zolpidem.

    Other medications used to manage seizures that do not fall into any particular category are gabapentin, levetiracetam, pregabalin, and topiramate.

    A significant goal of seizure management is to achieve complete control of all signs of seizure activity for as long as possible. The next goal is to minimize side effects.

    Treatment plans are formulated based on the underlying cause of the seizure, not by specific types of seizures or epilepsy syndromes.

    Nurse
    responsibilities while administering medical treatment for seizure

    1. The nurse is responsible for managing the client’s medication regimen, including monitoring effectiveness and side effects.
    2. The nurse is responsible for identifying problems with the medication therapy. This includes taking medications correctly, missing doses, or drug interactions.
    3. The nurse is responsible for educating the client and family members about their specific treatment plan.
    4. The nurse is also responsible for educating the client and family members about seizure first aid, signs and symptoms suggesting a change in medication, or adverse effects of medications.
    5. The nurse should be able to identify the side effects of anti-seizure medications resulting from either therapeutic or toxic levels. The nurse should consult with the physician if there are significant problems with the client’s medications or with the client’s overall health.
    6. The nurse is
      responsible for implementing lifestyle and behavioral modifications, such as controlling infections. The nurse should also assist the client in developing self-management skills to help ensure success with the treatment plan.

    Nurse responsibilities after a seizure occur.

    1. In the emergency situation, if an individual experiences a single generalized tonic-clonic seizure of more than 5 minutes duration, the nurse should take an incident history to determine the
      onset, duration, and aura (if present), if any.
    2. The nurse will also record a brief description of the seizure symptoms and follow seizure precautions as dictated by hospital policy. The patient will be re-evaluated after each episode of status epilepticus or prolonged seizures to confirm the diagnosis, document the seizure type, and estimate future risks.
    3. The nurse obtains baseline vital signs, including a temperature reading in the rectum or axilla (depending on hospital policy)
      and respiratory rate. The patient will be observed for 1-2 hours for recurrent seizures. If none occur, then they are discharged home with instructions to return for a follow-up visit. If recurrent seizures do occur, the patient will be admitted to the hospital and placed on an anticonvulsant immediately to prevent further seizure activity.
    4. The nurse should obtain a complete medication history, including all past illnesses, allergies, treatments, and current medications.

    Patients’
    responsibility for seizure management

    1. The client is responsible for managing the medications correctly, taking them at the scheduled time, and not missing doses.
    2. The client is responsible for informing health care providers about home remedies, alternative therapies, or other medication use that could affect clinical treatments.
    3. The client is also responsible for maintaining overall health, with nutrition and rest; avoiding excessive alcohol and caffeine;
      maintaining appropriate levels of stress; exercising regularly, and avoiding recreational drug use.
    4. The client is responsible for reporting signs or symptoms suggesting a change in treatment plan or adverse effects of medication – such as the onset of new seizure activity, failure to respond to initial treatments with AEDs, and side effects that cannot be tolerated.
    5. The client is responsible for maintaining a seizure journal so that patterns of seizure activity can be
      identified.
    6. The client is responsible for reporting any failure to reach therapeutic levels or the presence of therapeutic levels or toxic side effects.

    The responsibility of the nurse, when it comes to seizures, is to monitor and educate. Client should monitor their health by maintaining a seizure journal and reporting signs or symptoms suggesting adverse effects of medication or changes in the treatment plan.

    What is the goal of seizure treatment?

    Three main goals of epilepsy surgery are: Seizure freedom (no seizures) or free of disabling seizures. Improvement in quality of life and increased independence. Ability to decrease or stop taking anti-seizure medications.

    What are nursing care plan goals?

    The purpose of a nursing care plan is to document the patient's needs and wants, as well as the nursing interventions (or implementations) planned to meet these needs. As part of the patient's health record, the care plan is used to establish continuity of care.

    What is the priority nursing intervention for a patient that is having a seizure?

    Protect their airway! If your patient is having a seizure, you want to be sure their airway is protected, especially with those tonic-clonic seizures. During a seizure, patients are at high risk for aspiration of their saliva (or whatever happens to be in their mouth at the time).

    What are the priorities of care for a patient during and after a seizure?

    The priorities when caring for a patient who is seizing are to maintain a patent airway, protect the patient from injury, provide care during and following the seizure and documenting the event in the health record.

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