HAWLER MEDICAL UNIVERSITY

NURSING DEPARTMENT

EPILEPSY

PREPRED BY STUDENT:
XABAT JABAR
SUPERVISED BY:
DR. ADNAN

2020-2021
 Contents
List of figures..............................................................................................................................................1
Introduction.................................................................................................................................................2
Seizures.......................................................................................................................................................2
WHO defined epilepsy................................................................................................................................2
Types of epilepsy.........................................................................................................................................3
Risk factors..................................................................................................................................................5
Clinical manifestation..................................................................................................................................6
Nursing management...................................................................................................................................7
Nursing process...........................................................................................................................................8
Assessment..............................................................................................................................................8
Nursing diagnosis....................................................................................................................................8
Planning and goals...................................................................................................................................9
Nursing Interventions Rationale............................................................................................................10
Evaluation..............................................................................................................................................10
Conclusion.................................................................................................................................................11
Reference...................................................................................................................................................12

List of figures
Figure 1: type of epilepsy............................................................................................................................3

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Introduction
is a central nervous system (neurological) disorder in which brain activity becomes
abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of
awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races,
ethnic backgrounds and ages.

Seizures

 are physical findings or changes in behavior caused by uncontrolled electrical firing or

discharges from the nerve cells of the cerebral cortex and are characterized by sudden, brief
attacks of altered consciousness, motor activity and sensory phenomena.

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WHO defined epilepsy
as having two or more unprovoked seizures. Epilepsy is one of the world’s oldest recognized
conditions, with written records dating back to 4000Bc

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Types of epilepsy
Experts now divide epilepsy into two basic types based on the seizures you’re having:

Generalized epilepsy

Focal epilepsy

Figure 1: type of epilepsy

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Generalized epilepsy When they occur throughout the whole brain, it’s known as a

generalized seizure.

Focal epilepsy is a neurological condition in which the predominant symptom is

recurring seizures that affect one hemisphere (half) of the brain.

Genelized and focal epilepsy Focal onset seizures start in one area and can spread across

the brain and cause mild or severe symptoms, depending on how the electrical discharges

spread. Generalized seizures can start as focal seizures that spread to both sides of the

brain

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Risk factors
Certain factors may increase your risk of epilepsy:

Age. The onset of epilepsy is most common in children and older adults, but the

condition can occur at any age.

Family history. If you have a family history of epilepsy, you may be at an increased risk

of developing a seizure disorder.

Head injuries. Head injuries are responsible for some cases of epilepsy. You can reduce

your risk by wearing a seat belt while riding in a car and by wearing a helmet while

bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of

head injury.

Stroke and other vascular diseases. Stroke and other blood vessel (vascular) diseases can

lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce

your risk of these diseases, including limiting your intake of alcohol and avoiding

cigarettes, eating a healthy diet, and exercising regularly.

Dementia. Dementia can increase the risk of epilepsy in older adults.

Brain infections. Infections such as meningitis, which causes inflammation in your brain

or spinal cord, can increase your risk.

Seizures in childhood. High fevers in childhood can sometimes be associated with

seizures. Children who have seizures due to high fevers generally won’t develop

epilepsy. The risk of epilepsy increases if a child has a long seizure, another nervous

system condition or a family history of epilepsy.

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Clinical manifestation
Staring.

Temporary confusion.

Uncontrollable jerking movements of the arms and legs.

Stiffening of the body.

Loss of consciousness or awareness.

Breathing problems.

Loss of bowel or bladder control.

Falling suddenly for no apparent reason, especially when associated with loss of

consciousness

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Nursing management
Assess the patient for any signs of injury. Check also for limb displacement, as this may

indicate the patient has a fracture;

Patients’ behaviour may change if they think they are being restrained. Therefore, nurses

must consider their own personal safety;

Talk in a calm, reassuring voice;

If the patient gets up from the floor and starts to walk off before the

automatisms start, be prepared to go along as well. If it is known that the patient is likely to

remove his or her personal clothing, grab a blanket or towel to minimise any embarrassment

to the patient on recovery.

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Nursing process

Assessment
1: Suction and oxygen must be available.

2: Monitoring of vital signs is imperative, especially respiratory function.

3: Following the seizure, manage any resulting injuries.

4: Continue to monitor the patient’s airway, using suction as needed, and do not disturb the
patient if they fall sleep.

Nursing diagnosis
Neurological exam – to assess the patient’s cognition, motor capacity, and behavior

Neuropsychological test – to assess the patient’s speech, memory, and thinking skills

Blood test – to check for any infections or other risk factors that are related to epilepsy

Electroencephalogram (EEG) – to record the brain’s electrical activity by placing

electrodes on the scalp

bleeding, cysts, or tumor; functional MRI to measure the blood flow in the brain; PET

scan to visualize active areas of the brain by injecting a low-dose radioactive fluid

A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can

reveal abnormalities in your brain that might be causing your seizures, such as tumors,

bleeding and cysts.

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Planning and goals
Nursing care plan goals for patients with seizure includes maintaining a patent airway,
maintaining safety during an episode, and imparting knowledge and understanding about the
condition.

the common expected outcomes for seizure nursing care plan:

Patient will verbalize understanding of factors that contribute to the possibility of trauma

and or suffocation and take steps to correct the situation.

Patient will identify actions or measures to take when seizure activity occurs.

Patientwill identify and correct potential risk factors in the environment.

Patient will demonstrate behaviors, lifestyle changes to reduce risk factors and protect

self from injury.

Patient will modify environment as indicated to enhance safety.

Patient will maintain treatment regimen to control or eliminate seizure activity.

Patient will recognize the need for assistance to prevent accidents or injuries .

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Nursing Interventions Rationale
Nursing Assessment
Determine factors related to the individual situation, as listed in Risk Factors, and extent
of risk.
Influences the scope and intensity of interventions to manage the threat to safety.
Note client’s age, gender, developmental age, decision-making ability, level of cognition
or competence.
Affects the client’s ability to protect self and others, and influences the choice of
interventions and teaching.
Ascertain knowledge of various stimuli that may precipitate seizure activity. Alcohol,
various drugs, and other stimuli (loss of sleep, flashing lights, prolonged television
viewing) may increase brain activity, thereby increasing the potential for seizure activity.

Evaluation
Goals are met as evidenced by:

The patient or caregiver verbalized understanding of factors that contribute to the

possibility of trauma and or suffocation and take steps to correct the situation.
The patient or caregiver identified actions or measures to take when seizure activity
occurs.
The patient or caregiver identified and corrected potential risk factors in the environment.
The patient or caregiver demonstrated behaviors, lifestyle changes to reduce risk factors
and protect self from injury.
The patient or caregiver modified environment as indicated to enhance safety.
The patient or caregiver maintained treatment regimen to control or eliminate seizure
activity

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 The patient or caregiver recognized the need for assistance to prevent accidents or
injuries.

Conclusion
Epilepsy is a very complex condition, affecting large numbers of the population. Nurses must be
familiar with the different types of seizure and know how to manage them to ensure patients are
given appropriate care and medication. Around 70 per cent will be free of seizures if they have
the correct diagnosis and treatmen.

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Reference
Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., &
Zanotti, M. (2019). Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to
Planning Care. Mosby. [Link]
Joyce, B. M., & Jane, H. H. (2008). Medical surgical nursing. Clinical management for
positive outcome. Volume 1. Eight Edition. Saunders Elsevier. St. Louis. Missouri.
[Link]
Carpenito-Moyet, L. J. (2006). Handbook of nursing diagnosis. Lippincott Williams &
Wilkins. [Link]
Crocker, J. (1999). Social stigma and self-esteem: Situational construction of self-worth.
Journal of experimental social psychology, 35(1), 89-107. [Link]
Kavanagh, A., & McLoughlin, D. M. (2009). Electroconvulsive therapy and nursing care.
British journal of nursing, 18(22), 1370-1370. [Link]
Videbeck, S. L. (2010). Psychiatric-mental health nursing. Lippincott Williams &
Wilkins. [Lin

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