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S E I Z U R E Dr. Anthony  P.  Toledo MSNET2 D I S O R D E R
DEFINITION Involuntary muscle contractions caused by abnormal discharged of electrical impulses from nerve cells  Seizure
CLASSIFICATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
Seizure CLASSIFICATION ,[object Object]
Seizure CLASSIFICATION ,[object Object]
CLASSIFICATION ,[object Object],Seizure TYPE DESCRIPTION SIGNS AND SYMPTOMS GENERALIZED ABSENCE (petit mal) - Sudden onset; - Lasts 5 to 10 seconds; - Can have 100 daily; - Precipitated by stress; - Hyperventilation; - Hypoglycemia; - Fatigue; - Differentiated from day dreaming - Loss of responsiveness, but continued ability to maintain posture control and not fall; - Twitching eyelids; - Lip smacking; - No postictal symptoms MYOCLONIC - Movement disorder(not a seizure); - Seen as child awakens or falls asleep; - May be precipitated by touch or visual stimuli; - Focal or generalized; - Symmetrical or asymmetrical - No loss of consciousness; - Sudden; - Brief; - Shocklike involuntary contraction of one muscle group
Seizure CLASSIFICATION ,[object Object]
CLASSIFICATION ,[object Object],Seizure TYPE DESCRIPTION SIGNS AND SYMPTOMS GENERALIZED CLONIC  - Opposing muscles contract and relax alternately in rhythmic pattern; - May occur in one limb more than others - Mucus production  TONIC Muscles are maintained in continuous contracted state (rigid posture) - Variable loss of consciousness; - Pupils dilate; - Eyes roll up; - Glottis closes; - Possible incontinence; - May foam at mouth TONIC-CLONIC (grand mal, major motor)  Violent total body seizure  - Aura; - Tonic first(20 – 40 seconds); - Clonic next; - Postictal symptoms
Seizure CLASSIFICATION ,[object Object]
CLASSIFICATION ,[object Object],Seizure TYPE DESCRIPTION SIGNS AND SYMPTOMS GENERALIZED ATONIC  Drop and fall attack; Needs to wear protected helmet Loss of posture tone  AKINETIC  Sudden brief loss of muscle tone or posture Temporary loss of consciousness
CLASSIFICATION ,[object Object],Seizure TYPE DESCRIPTION SIGNS AND SYMPTOMS PARTIAL  SIMPLE PARTIAL  Symptoms confined to one hemisphere  - May have motor (change in posture),  - Sensory (hallucinations); - Autonomic (flushing, tachycardia) symptoms; - No loss of consciousness  COMPLEX PARTIAL  Begins in one focal area, but spreads to both hemispheres (more common in adult)  - Loss of consciousness; - Aura of visual disturbances; - Postictal symptoms
CLASSIFICATION ,[object Object],Seizure TYPE DESCRIPTION SIGNS AND SYMPTOMS UNCLASSIFIED  FEBRILE - Seizure threshold lowered by elevated temperature; - Only one seizure per fever; - Common in 4% of population under age 5; - Occurs when temperature is rapidly rising -Lasts less than 5 minutes; - Generalized; - Transient and nonprogressive; - Doesn’t generally result in brain damage; - EEG is normal after 2 weeks STATUS EPILEPTICUS Prolonged and frequent repetition of seizures without interruption; results in anoxia and cardiac and respiratory arrest - Consciousness not regained between seizures;  - Lasts more than 30 minutes
CAUSES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
Seizure PATHOPHYSIOLOGY ,[object Object],[object Object]
ASSESSMENT FINDINGS ,[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
DIAGNOSTIC TEST FINDINGS ,[object Object],[object Object],[object Object],[object Object],Seizure
MEDICAL MANAGEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
NURSING CARE DURING SEIZURE   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
NURSING CARE DURING SEIZURE   (cont’d) ,[object Object],[object Object],[object Object],Seizure
Seizure
Seizure ,[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING CARE AFTER THE SEIZURE ,[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
PATIENT EDUCATION   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Seizure
E P I L E P T I C U S S T A T U S
DEFINITION Status Epilepticus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CAUSES Status Epilepticus ,[object Object],[object Object],[object Object],In infants In adults  ,[object Object],[object Object],[object Object],[object Object]
PATHOPHYSIOLOGY Status Epilepticus The exact pathophysiology of why seizure evolves into status  is complex and not fully understood
DIAGNOSTIC FINDINGS Status Epilepticus ,[object Object],[object Object]
MEDICAL MANAGEMENT Status Epilepticus GOAL ,[object Object],[object Object],[object Object]
MEDICAL MANAGEMENT  (cont’d) Status Epilepticus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT Status Epilepticus ,[object Object],[object Object],[object Object],[object Object]
RECOVERY AND REHABILITATION Status Epilepticus ,[object Object],[object Object],[object Object]
E P I L E P S Y
DEFINITION Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PATHOPHYSIOLOGY Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CAUSES Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epilepsy Causes of newly diagnosed cases of epilepsy. Despite growing knowledge of causes, 70% of cases are of unknown cause. (from Hauser, 1990)
Epilepsy
Epilepsy
Epilepsy
Epilepsy
Epilepsy
DIAGNOSTIC FINDING: Epilepsy ,[object Object],[object Object]
DIAGNOSTIC FINDING:  (cont’d) Epilepsy ,[object Object],[object Object],[object Object]
MEDICAL MANAGEMENT Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MEDICAL MANAGEMENT  (cont’d) Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT  (cont’d) Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT  (cont’d) Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
H E A D A C H E
[object Object],[object Object],[object Object],DEFINITION Headache
COMMON LOCATIONS OF HEADACHE PAIN Headache
Headache The brain itself is not sensitive to pain, because it lacks pain-sensitive nerve fibers. Several areas of the head can hurt, including a network of nerves which extend over the scalp and certain nerves in the face, mouth and throat. The meninges and the blood vessels do not have pain receptors. Headache often results from traction to or irritation of the meninges and blood vessels. The muscle of the head may similarly sensitive to pain PATHOPHYSIOLOGY
Headache TYPES OF HEADACHE
Headache TYPES OF HEADACHE
Headache TYPES OF HEADACHE
Headache TYPES OF HEADACHE
Headache TYPES OF HEADACHE ,[object Object],[object Object],[object Object]
Headache TYPES OF HEADACHE
Headache TYPES OF SURGICAL PROCEDURES
Headache
Headache TYPES OF HEADACHE 1. Primary Headache ,[object Object],[object Object]
Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TYPES OF HEADACHE 1. Primary headache
Headache ,[object Object],KINDS OF MIGRAINE ,[object Object],[object Object],[object Object],[object Object],TYPES OF HEADACHE 1. Primary headache
Headache ,[object Object],KINDS OF MIGRAINE  (cont’d) TYPES OF HEADACHE 1. Primary headache ,[object Object],[object Object],[object Object]
Headache CAUSE AND SYMTOMS CAUSE SYMTOMS dilatation of blood vessels  a. nausea and vomiting b. chills c. fatigue d. irritability e. sweating f. edema
Headache CAUSE AND SYMTOMS
Headache FOUR PHASES OF MIGRAINE WITH AURA 1. PRODROME-  experienced by 60% of patient symptoms:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache 2. AURA PHASE  ,[object Object],[object Object],[object Object],[object Object],FOUR PHASES OF MIGRAINE WITH AURA
Headache 2. AURA PHASE  (cont’d)   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],FOUR PHASES OF MIGRAINE WITH AURA
Headache 3. Headache Phase ,[object Object],[object Object],[object Object],[object Object],FOUR PHASES OF MIGRAINE WITH AURA
Headache 4. Recovery Phase ,[object Object],[object Object],[object Object],[object Object],[object Object],FOUR PHASES OF MIGRAINE WITH AURA
Headache DIAGNOSTIC TEST FINDINGS ,[object Object],[object Object],[object Object],[object Object]
Headache TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object]
Headache TREATMENT  (cont’d) chocolate,  nuts,  onions,  cow’s milk,  wheat,  egg,  orange,  benzoic acid, cheese,  tomato AVOID FOODS LIKE:
Headache B.  TENSION  HEADACHE ,[object Object],[object Object],[object Object],[object Object],[object Object],TYPES OF HEADACHE 1. Primary headache  (cont’d)
Headache SYMTOMS AND TREATMENT SYMPTOMS TREATMENT sustained contraction of  head and neck muscles ,[object Object],[object Object],[object Object]
Headache C. CLUSTER  HEADACHE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TYPES OF HEADACHE 1. Primary headache  (cont’d)
Headache SYMTOMS AND TREATMENT SYMPTOMS TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache D. CRANIAL  ARTERITIS Cause of headache in older population, reaching its greatest incidence in those  older than 70 years old TYPES OF HEADACHE 1. Primary headache  (cont’d)
Headache SYMTOMS AND TREATMENT SYMPTOMS TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],Early administration of corticosteroid to prevent the possibility of loss of vision due to vascular occlusion or rupture of the involved artery
Headache TYPES OF HEADACHE  (cont’d) 2.  Secondary Headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache ASSESSMENT ,[object Object],[object Object],[object Object]
Headache DIAGNOSTIC EVALUATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache FACTORS PRECIPITATING HEADACHE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache NURSING MANAGEMENT ,[object Object],[object Object],[object Object]
Headache NURSING MANAGEMENT  (cont’d) ,[object Object],[object Object],[object Object],[object Object]
Headache NURSING MANAGEMENT  (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A L T E R E D  LEVEL OF CONSCIOUSNESS  CONSCIOUSNESS
Altered Level of Consciousness   ,[object Object],[object Object]
COMA ,[object Object],[object Object],[object Object],Altered Level of Consciousness
[object Object],Altered Level of Consciousness   AKINETIC MUTISM
PERSISTENT VEGETATIVE STATE ,[object Object],Altered Level of Consciousness
PATHOPHYSIOLOGY ,[object Object],Altered Level of Consciousness
CAUSES   Altered Level of Consciousness   ,[object Object],[object Object],[object Object]
CLINICAL MANIFESTATIONS Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object],[object Object]
ASSESSMENTS  Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object]
DIAGNOSTIC FINDINGS  Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COMPLICATIONS Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object]
MEDICAL MANAGEMENT Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT Altered Level of Consciousness   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Maintaining  the airway
NURSING MANAGEMENT  (cont’d) Altered Level of Consciousness   ,[object Object],[object Object],[object Object],Supporting  the  Family
NURSING MANAGEMENT  (cont’d) Altered Level of Consciousness   ,[object Object],[object Object],[object Object],Promoting  Sensory  Stimulation
NURSING MANAGEMENT  (cont’d) Altered Level of Consciousness   ,[object Object],[object Object],Attaining  Self  Care
I N T R A C R A N I A L  I N C R E A S E D  P R E S S U R E
Increased Intracranial Pressure Is the result of the amount of brain tissue, blood, and cerebrospinal fluid (CSF) within the skull at any one time.  The volume and pressure of these three components are usually in a state of equilibrium.  Because there is limited space for expansion within the skull, an increase in any of these components causes a change in the volume of the others by displacing or shifting CSF, increasing the absorption of CSF, or decreasing cerebral blood volume.  The normal ICP is 10 to 20 mm Hg. Although elevated ICP is most commonly associated with head injury, an elevated pressure may be seen secondary to brain tumors, subarachnoid hemorrhage, and toxic and vital encephathies.  Increased ICP from any cause affects cerebral perfusion and produces distortion and shifts of brain tissue
CLINIICAL MANIFESTATION Increased Intracranial Pressure When ICP increases to the point where the brain’s ability to adjust has reached its limits, neural function is impaired.  Increased ICP is manifested by changes in level of consciousness and abnormal respiratory and vasomotor responses.
CLINIICAL MANIFESTATION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ASSESSMENT AND DIAGNOSTIC METHODS   Increased Intracranial Pressure ,[object Object],[object Object]
MEDICAL MANAGEMENT Increased Intracranial Pressure Increased ICP is a true emergency and must be treated promptly. Immediate management involves decreasing cerebral edema, lowering the volume of CSF, and decreasing blood volume while maintaining cerebral perfusion.
PHARMACOLOGIC THERAPY Increased Intracranial Pressure ,[object Object],[object Object],[object Object]
NURSING MANAGEMENT   Increased Intracranial Pressure T H E U N C O N S C I O U S P A T I E N T  ASSESSMENT  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NURSING MANAGEMENT   Increased Intracranial Pressure NURSING ALERT! Changes in vital signs may be a late sign of increased ICP.  As ICP increases, pulse rate and respiratory rate decreased, and blood pressure and temperature rise. Observe for widening pulse pressure, bradycardia, and respiratory irregularity: Cheyne-Storked breathing and ataxic breathing (Cushing’s triad). Widened pulse pressure is a serious development.  Immediate surgical intervention is indicated if the major circulation begins to decrease as a result of brain compression.
DIAGNOSIS Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],NURSING DIAGNOSES
DIAGNOSIS  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],COLLABORATIVE PROBLEMS / POTENTIAL COMPLICATIONS
PLANNING OF GOALS Increased Intracranial Pressure The major goals of the patient may include adequate cerebral tissue perfusion through reduction of ICP, normal respiration, patent airways, restored fluid balance, normal urine and bowel elimination, absence of infection, and absence of complications.
NURSING INTERVENTION Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],MAINTAINING A PATENT AIRWAY
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],ATTAINING NORMAL RESPIRATORY PATTERN
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],PRESERVING AND IMPROVING CEREBRAL TISSUE PERFUSION
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PRESERVING AND IMPROVING CEREBRAL TISSUE PERFUSION (cont’d)
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],MAINTAINING NEGATIVE FLUID BALANCE
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],PREVENTING INFECTION
NURSING INTERVENTION  (cont’d) Increased Intracranial Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],MONITORING AND MANAGING POTENTION COMPLICATIONS
EVALUATION Increased Intracranial Pressure EXPECTED PATIENT OUTCOMES  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
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Seizure Ppt Etc

  • 1. S E I Z U R E Dr. Anthony P. Toledo MSNET2 D I S O R D E R
  • 2. DEFINITION Involuntary muscle contractions caused by abnormal discharged of electrical impulses from nerve cells Seizure
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  • 24. E P I L E P T I C U S S T A T U S
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  • 27. PATHOPHYSIOLOGY Status Epilepticus The exact pathophysiology of why seizure evolves into status is complex and not fully understood
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  • 33. E P I L E P S Y
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  • 37. Epilepsy Causes of newly diagnosed cases of epilepsy. Despite growing knowledge of causes, 70% of cases are of unknown cause. (from Hauser, 1990)
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  • 50. H E A D A C H E
  • 51.
  • 52. COMMON LOCATIONS OF HEADACHE PAIN Headache
  • 53. Headache The brain itself is not sensitive to pain, because it lacks pain-sensitive nerve fibers. Several areas of the head can hurt, including a network of nerves which extend over the scalp and certain nerves in the face, mouth and throat. The meninges and the blood vessels do not have pain receptors. Headache often results from traction to or irritation of the meninges and blood vessels. The muscle of the head may similarly sensitive to pain PATHOPHYSIOLOGY
  • 54. Headache TYPES OF HEADACHE
  • 55. Headache TYPES OF HEADACHE
  • 56. Headache TYPES OF HEADACHE
  • 57. Headache TYPES OF HEADACHE
  • 58.
  • 59. Headache TYPES OF HEADACHE
  • 60. Headache TYPES OF SURGICAL PROCEDURES
  • 62.
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  • 65.
  • 66. Headache CAUSE AND SYMTOMS CAUSE SYMTOMS dilatation of blood vessels a. nausea and vomiting b. chills c. fatigue d. irritability e. sweating f. edema
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  • 75. Headache TREATMENT (cont’d) chocolate, nuts, onions, cow’s milk, wheat, egg, orange, benzoic acid, cheese, tomato AVOID FOODS LIKE:
  • 76.
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  • 79.
  • 80. Headache D. CRANIAL ARTERITIS Cause of headache in older population, reaching its greatest incidence in those older than 70 years old TYPES OF HEADACHE 1. Primary headache (cont’d)
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  • 89. A L T E R E D LEVEL OF CONSCIOUSNESS CONSCIOUSNESS
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  • 105. I N T R A C R A N I A L I N C R E A S E D P R E S S U R E
  • 106. Increased Intracranial Pressure Is the result of the amount of brain tissue, blood, and cerebrospinal fluid (CSF) within the skull at any one time. The volume and pressure of these three components are usually in a state of equilibrium. Because there is limited space for expansion within the skull, an increase in any of these components causes a change in the volume of the others by displacing or shifting CSF, increasing the absorption of CSF, or decreasing cerebral blood volume. The normal ICP is 10 to 20 mm Hg. Although elevated ICP is most commonly associated with head injury, an elevated pressure may be seen secondary to brain tumors, subarachnoid hemorrhage, and toxic and vital encephathies. Increased ICP from any cause affects cerebral perfusion and produces distortion and shifts of brain tissue
  • 107. CLINIICAL MANIFESTATION Increased Intracranial Pressure When ICP increases to the point where the brain’s ability to adjust has reached its limits, neural function is impaired. Increased ICP is manifested by changes in level of consciousness and abnormal respiratory and vasomotor responses.
  • 108.
  • 109.
  • 110. MEDICAL MANAGEMENT Increased Intracranial Pressure Increased ICP is a true emergency and must be treated promptly. Immediate management involves decreasing cerebral edema, lowering the volume of CSF, and decreasing blood volume while maintaining cerebral perfusion.
  • 111.
  • 112.
  • 113. NURSING MANAGEMENT Increased Intracranial Pressure NURSING ALERT! Changes in vital signs may be a late sign of increased ICP. As ICP increases, pulse rate and respiratory rate decreased, and blood pressure and temperature rise. Observe for widening pulse pressure, bradycardia, and respiratory irregularity: Cheyne-Storked breathing and ataxic breathing (Cushing’s triad). Widened pulse pressure is a serious development. Immediate surgical intervention is indicated if the major circulation begins to decrease as a result of brain compression.
  • 114.
  • 115.
  • 116. PLANNING OF GOALS Increased Intracranial Pressure The major goals of the patient may include adequate cerebral tissue perfusion through reduction of ICP, normal respiration, patent airways, restored fluid balance, normal urine and bowel elimination, absence of infection, and absence of complications.
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