Ictal when the seizure occurs epileptic cry simultaneous contractions of the

Ictal when the seizure occurs epileptic cry

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Ictal (when the seizure occurs): epileptic cry (simultaneous contractions of the diaphragm and chest muscles causes cry); loss of consciousness (LOC). o Observe movement of head and eyes, muscle rigidity, progression of seizure, and the duration and LOC, incontinence of stool and urine. o Protect from injury; turn to side and loosen clothes. o DO NOT put anything in mouth Postictal (after seizure): does not remember seizure, confused, hard to arouse from sleep. o Assess airway, breathing, vital signs, neurologic checks; keep on side and clean up the patient; reorient the patient as the patient awakens. o Collaborative complications include: Respiratory distress or failure, Pneumonia, Aspiration and Pressure ulcer Plan of care for a patient experiencing a seizure: Observation and documentation of patient signs and symptoms before, during, and after seizure (timing & writing details including onset, body part affected, LOC, muscle tone, pupils, cyanosis, altered salivation, incontinence.) Nursing actions during seizure for patient safety and protection (Safety includes maintaining airway, protecting patient from harm, DO NOT restrain, DO NOT place objects inside the mouth and observe and record event.) After seizure care to prevent complications Refer to Chart 66-4 Women’s Health and AEDs (anti-epileptic drugs): Folate supplementation is recommended to women of childbearing age. Reduce risk of birth defects due to AEDs. AEDs can diminish effectiveness of oral contraceptives. AED can triple failure rate of oral contraceptives. Other things to incorporate in teaching: Discuss that the patient should wear a medical alert bracelet. The patient is not allowed to drive. The patient should be aware of the medication that they are on and if they require blood draws. How do they take the medication? Does it interfere with another medication?
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Parkinson’s Disease Parkinson’s disease: gradual onset disease, usually starts off with minor tremors. The biggest thing with theses populations is safety (shuffling gait problems). As the disease progresses, the patients may have difficulty with swallowing, so we have to monitor them carefully for that. Think about patient safety, supporting them and trying to make them gain or keep their independence as long as possible. Mask like expression makes it hard to assess them sometimes. From lecture notes: Onset of Parkinson’s Disease is usually gradual, after 50 (slowly progressive). Three cardinal symptoms include; -- Tremor – gradual onset usually unilateral but can differ from person to person. Rigidity-stiffness of the arms, legs, face, and posture are common. Early in the disease, the patient may complain of shoulder pain due to rigidity and bradykinesia. Other symptoms include mask-like blank expression, stooped posture and pill-rolling tremors, possible mental deterioration, depression, shuffling & propulsive gait. It rarely occurs in black population.
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  • Fall '16
  • Denise Cauble
  • Nursing, Wound infection

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