الثلاثاء، 28 أغسطس 2018

259-Status Epilepticus

About
Acute emergency whereby client has a continuous seizure state causing hypoxemia to the brain.
Assess
Time, length, duration, quality of seizure state; airway, neurological status, post-ictal state, precipitating factors, vital signs, pulse-oximetry
Complications
Brain anoxia, death
Diagnosis
  • Impaired gas exchange related to altered oxygenation.
  • Risk for injury related to constant seizure state.
Goals
  • The client will be free from seizures.
  • The client will be free from injury.
  • The client will have a pulse-oximetry > 94%.
Interventions
  • Establish and maintain patent airway.
  • Administer oxygen.
  • Administer benzodiazepines ( ativan, valium) to immediately interrupt seizure state.
  • Follow up with long acting seizure medications to prevent return of seizure state ( dilantin, phenobarbitol).
  • Maintain a patent IV.
  • Pad side-rails.
  • Assess neurological status and vital signs frequently.
  • Monitor for return of seizure state or symptoms.
  • Treat underlying cause of seizure ( fever, ETOH withdrawal, Acid-base or electrolyte disturbances, etc) or initiate treatment plan for epilepsy.
  • Teach client about the medications he/ she is receiving and potential side-effects.
  • Prepare for diagnostic tests as indicated.
  • Monitor for signs/ symptoms of complications.

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