Seizures are caused by abnormal discharge of neurons that lead to physical and behavioural disturbances. "Pediatric Hospital Medicine: Textbook Of Inpatient Management," by Ronald M. Perkin, James D Swift and Dale A Newton, says that seizures should be considered as symptoms of central or systemic nervous system dysfunction. Nursing diagnoses for seizures may be formulated based on problems with safety, medication therapy and knowledge of the condition. "Risk for trauma" is a nursing diagnosis for seizures.
Types of Seizures
There are different types of seizures. Generalized tonic-clonic seizures involve muscle contraction, foaming at the mouth with rhythmic contraction and relaxation of the muscles or jerking and loss of consciousness. In generalized absence seizures, there is loss of awareness and sudden loss of voluntary use of the muscles. In this type of seizure, a patient may have a vacant stare.
Simple partial seizures cause jerking movements in one particular part of the body while a person is conscious. Complex partial seizures, on the other hand, may begin as simple partial seizures after which loss of consciousness occurs. Status epilepticus is a state in which an individual experiences continuous seizures all at once. It is a medical emergency and could lead to death.
In order to formulate a nursing diagnosis for patients who suffer from seizures, nurses conduct interviews to find out how much a patient knows about a seizure and its treatment; how often they have seizures and if they know how long they last, as well as the type of seizures they experience. They also may inquire about factors that may precipitate seizures such as odors or fatigue. Nurses also check to see if the patient has barriers to obtaining seizure medications.
After gathering as much information as possible, the nurse then analyzes the information for possible problems that a patient with seizures may have or could develop. Some of these problems could be little to no knowledge about seizures, difficulty taking anti-seizure medication and the possibility of injury during a seizure. Based on these problems, a nurse can formulate nursing diagnoses such as "deficient knowledge," "risk for trauma" and "non-compliance: therapy."
A care plan for a patient who has a seizure disorder focuses on ensuring that the patient and caregivers of the patient are educated about the disease process behind this disorder, its treatment plan, consequences of not sticking to the treatment plan and safety measures necessary to prevent injuries. The care plan contains nursing interventions that address these goals.
"All in One Care Planning Resource," by Pamela L. Swearingen, suggests that nursing interventions for keeping the patient safe include taking seizure precautions such as:
- padding the side rails of the bed with blankets
- keeping the bed in a low position (# 'inline-reference::"All in One Care Planning Resource"; Pamela L
et.al. ; 2004'). These intervention may prevent injury if a seizure occurs. During a seizure, the nurse can keep the client safe by placing the patient in a side lying position and loosening all constrictive clothing to promote breathing and prevent low oxygen levels.
Finding solutions to problems that may prevent a patient from taking seizure medications is an intervention that addresses the nursing diagnosis of "noncompliance- therapy." Some of these problems could be little to no knowledge about seizures, difficulty taking anti-seizure medication and the possibility of injury during a seizure. Based on these problems, a nurse can formulate nursing diagnoses such as "deficient knowledge," "risk for trauma" and "non-compliance: therapy."
- "All in One Care Planning Resource"; Pamela L. Swearingen, RN, et.al.; 2004
- "Nursing Diagnosis: Application To Clinical Practice" Lynda Juall Carpenito-Moyet; 2007
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