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 SEIZURE Disorders In Children

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مُساهمةموضوع: SEIZURE Disorders In Children   الخميس 02 أبريل 2009, 16:53

[This is my lecture for presentation >.....

Topics To DISCUSE

Definition
-Types of seizure
Diagnostic Evaluation
-Drugs
commonly used for the control of seizures
-Nursing assessment
Nursing Intervention
- Family Education & Health
Maintenance


Definition

Seizures ( also known as epileptic seizures and if
recurrent , epilepsy ) are thought to result from disturbances in the cells of
the brain that cause them to give off abnormal, recurrent , uncontrolled
electrical discharge They are relatively common in children. Being more
prevalent during the first 2 years than at any other time in life

-Types of seizure

A- Partial Seizures (seizures bgining locally )
1- Simple
; focal motor or sensory effect , no loss of consciousness
2- comlea :
congitive , psychosensory ,psychomotor , or affective
effect , brief loss of
cnscious

C- Status epilecticus ; prologed partial or generalized
seizures

without recovery between attackes : many completely
exhaust the
clint and lead
to death

Seizures (bilateral symmetric and without
local onset )
1- Absence (petit mal)
2- Myoclonic
3-Tonic-clonic (
Grand mal )


Diagnostic Evaluation

A- electroencephalogram
The EEG shows characteristic abnormalities during
seizures and with generalized seizures , between seizures as well .
B- laboratory studies
1- serum electrolytes (hyponatermia )
2- toxicology serum (drug overdose )
3- blood culture( fever ,CNS infection )
4- lumber puncture

Treatment

1- selection of the most effective drugs
depends on correct identification of the clinical seizure type .
2- A
desirable drug level ; is that will prevent seizure without producing
undesirable side effect.
3- dosages are adjusted according to blood level and
clinical sign.

4- Accurate timing
5- Enteric-coated tablet
6- symptoms may not be controlled 100%
7- Medication is often not discontinued
until 2to3years after last attack.
8- Weaning from mediation should always be gradual

Drug commonly used
PHENOBARBITAL (luminal )
Maentenance
dosage
3-8 mg /kg per day given qid or bd

PHENYTOIN (Dilantin )

Loding dose : 15mg/ kg
Mantenance ;4-7mg/kg
per day given qid or bd

ETHOSURIMEDE
Maintenance :20-40mg/kg
per day given qid by oral
DIAZEPAM (valium )
I/V dosage 0.2-0.3mg /kg
to maximum 10mg

rectal dosage 0.5mg/kg

TEGRATOL
20-30-MG/KG PER
day tid or
qid maximum
dose of 1000mg/d

Nursing Assessment

1-During seizure assess the following
A-any indication of difficulty in breathing

B- behavior before the seizure
D-type of movement observed
E- time seizure begin and ended
F- site where twitching or contraction began
G- movement of the eyes and change in pupil size h- color change , mouth (tongue bitten )

2- After seizure ,assess the following
A- degree of memory
for recent event
B- type of speech
C- coordination ,paralysis or
weakness
D- length of time the child is posited
E- papillary
reaction
F- vital signs


Nursing Intervention
A-Ensuring
safety during a seizure
1-use preventive measures
A- Remove hard toys
from the bed
B-pale the sides of the bed or side rails
C-have a suction
machine available
D-Have an emergency oxygen
2- Make sure the child can
be readily observed
3- during seizure monitor vital signs &assess
neurological status


During Seizure Take the Following Emergency
Action


A- clear the area around the child
B-Don’t restrain the child

C-without limiting the movement of the child loosen any tight clothing
,particularly around the neck
D- If vomiting occurs ,turn the child on one
side
E- place a small folded blanket under the head to prevent trauma


2-suction the vomits or saliva& administer oxygen
3- in an
infant or child,if the seizure seem to be the result of high fever cool the
child gradually , using taped water
4- After the seizure ,place the child in
a sideling position .


Family Education * Health maintenance

1-describe completely any examination , treatment
That the child is
receiving
2-Provide information regarding the disease
3-prepare the
parents for the fact that it may take several months of regulating drug dosage
before adequate control is obtained .
4- Teach the parents the factors that
may precipitate a seizure


THANK YOU

_________________




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معاينة صفحة البيانات الشخصي للعضو http://nursing.goo-done.com
اشرف ابو العز
ملاك نشيط
ملاك نشيط


عدد الرسائل : 142
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تاريخ التسجيل : 17/04/2009

مُساهمةموضوع: رد: SEIZURE Disorders In Children   الجمعة 26 يونيو 2009, 11:33

الأخت القديرة رشروشه
بارك الله فيكِ
جهد طيب يستحق الشكر والتحيه

ودمتى بخير وسعادة
اشرف ابو العز
الرجوع الى أعلى الصفحة اذهب الى الأسفل
معاينة صفحة البيانات الشخصي للعضو
 
SEIZURE Disorders In Children
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