Nursing Care and Management

Seizures

Nursing Assessment

  • Was the seizure witnessed from the beginning?
  • Were there any warning signs?
  • What type of body movement was noted?
  • How long did it last?
  • Was the patient unconscious throughout the seizure?
  • Was there any weakness or paralysis of the extremities post seizure?
  • Were there any injuries noted?
  • Was the patient in a postictal state after the seizure?

Nursing Diagnosis

  • Risk for injury related to seizure activity
  • Ineffective airway clearance
  • Risk for aspiration
  • Fear related to the possibility of seizures
  • Ineffective coping related to stresses imposed by epilepsy
  • Deficient knowledge related to epilepsy and its control
  • Noncompliance: medication

Interventions:

Before (and During) Seizure Care:

  • Pad side rails
  • Remove unnecessary furniture
  • Ease the patient to the floor
  • Provide privacy if possible
  • If patient experiences an aura, have them lie down immediately to prevent injury
  • Remove eyeglasses and loosen restrictive clothing
  • Do not try to force anything into the mouth
  • Stay with the patient throughout the seizure to ensure safety
  • Time the seizure (seizure events often seem much longer then they really are)
  • Provide O2 and suction as needed

Post Seizure Care:

  • Lay the patient on their side to drain secretions
  • Maintain a patent airway
  • Suction secretions if necessary to prevent aspiration
  • Allow the patient to sleep after the seizure
  • Reorient the patient as needed

Goals

  • Patient remains free of injury
  • Patient is compliant with medications and treatment
  • Patient verbalizes the need to take medication routinely
  • Patient and family verbalize appropriate measure to take during a seizure
  • Patient verbalizes a decrease in fear
  • Patient and family display effective coping skills
  • Exhibits knowledge and understanding of epilepsy
  • Verbalizes side effects of medications
  • Patient verbalizes that they will avoid alcohol
  • Patient displays an absence of complications
  • Decrease in seizure activity

Patient Education

  • Avoid tub baths without supervision
  • Take medications daily
  • Never discontinue medications without speaking with the physician
  • Notify the physician if they cannot take medication due to illness
  • See the physician regularly for exams and lab work
  • Understand and report signs of toxicity
  • Avoid activities requiring alertness until the effects of medication are understood
  • Avoid OTC medications and herbal supplements
  • Wear a medic alert bracelet
  • Avoid seizure triggers including alcohol, stress, caffeine, constipation, fever, hyperventilation, and hypoglycemia
  • Never swim alone
  • Exercise regularly
  • Avoid temperature extremes
  • Adequate sleep
  • Utilize the Epilepsy Foundation of America