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Friday, January 30, 2009

nursing care plan for Epilepsy

Epilepsy is a symptom release due to electrical activity and the periodic eksesif of neuron serebrum which may cause loss of consciousness, motion involunter, sensorik abnormal phenomenon, the increase of activity and various autonomous psychological disturbances

Idiopatik (primer, essensial)
On this type, there can not be found in an organic brain lesi. Does not begin with fokal attacks. Disturbances in the functional areas of the brain that have the basic ability to control the activities korteks.

Symptomatic aberration due to brain
Epilepsy seizures symptomatic of an organic brain disease. For example, because of fever, brain disease degeneratif difus, infark, enchepalitis, abses, serebrum tumor, scar network after head injury, anoksia, toksemia, hipogliklemia, hipokalasemia, symptoms or drop out of medicine.

The emergence of a strain is probably the imbalance between asetilkolin and GABA (gama amino acid butirat), is neurotransmitter brain cells. Asetilkolin cause depolarisasi, the rise in the number of excessive strain. GABA is being hiperpolarissasi cause, which would otherwise degrade eksitabilitas and the occurrence of convulsions. Various conditions that interfere with the metabolism of the brain such as metabolik, poisons, drugs and dropping out of some drugs, can cause the same effect.

1. Grand mal ( tonik-klonik)
Tonic phase
Marked with all the muscle contraction, lid open, arms upraised, abduksi, FLEKSI elbow joints, leg also FLEKSI (bending). After FLEKSI immediately followed by an extension with the shrieking epilepsy a few seconds. Neck and back vaulted into the position opistotonik, arm and leg extension also. Lasts between 10-20 seconds.

klonik Phase
Lasted for about 30 seconds. Shows the movement spasmus FLEKSI flit with relaxation. People can bite talking, sianosis, hypertension, takhicardi, hiperhodrosis, midriasis, increased salivas

Post-attack phase (comma)
All muscle activity stops. In a 15-minute awareness of the lembali recover. Awareness will be restored to normal within 1-2 hours. People feel lethargic, muscle, muscle aches and headaches.

2.Petit mal
It is a quiet epilepsy. People are usually children or young adults. During the summer, suddenly stop, there is often a small movement such as movement-eyelid movement, chewing, lip movements. The attack ended in 60 seconds. Awareness also be normal. In a day, the attack can be 10-20 times


a. Simple (there is no interference awareness)
b. Complex (there is a disruption of awareness)

Things that need to be patient in the epilepsy treatment, among others:
1. The right diagnosis
2. Choose the right medicine
3. Start with a single drug
4. Dose grown in scope therapeutic in serum
5. Note the duration of drug effect to determine the frequency of drug
6. increasing doses or drugs should not have to consider progress in therapy
7. Time delivery of drugs that benefit patients
8. Monitoring adherence because epilepsy patients need long-term treatment. Usually drugs anti epilepsy gradually stopped after the patients 2-3 years free of a strain with EEG monitoring. Some have a need medication for life, so that patient adherence, the family and the community is necessary for successful treatment.

nursing diagnosis that may occur
The risk of injury
The risk of aspiration


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