Discuss inclusive of the data analysis of a case study carried of a client who had recurrent seizures.

Discuss inclusive of the data analysis of a case study carried of a client who had recurrent seizures.

 

Epilepsy is a neurological disorder which is characterized by seizures which recurrently occur without being provoked. The discussion is inclusive of the data analysis of a case study carried of a client who had recurrent seizures. There were different diagnoses made to enhance the most effective medication which included the simple partial seizures, complex partial seizures and tonic-clonic seizures which are said to be more generalized. The three diagnoses were chosen under an agreement of the nurse and the client and their positive results lead to the next diagnoses. In every diagnoses there are several characteristics related to the seizure even though they seem to relate but the impact of each seizure increases depending on how they follow each other. There are also the outcomes and the intervention in nursing in every diagnosis. Based on the discussion the partnership between the customers with the nursing care has some impacts as the quality of service is always positively improved.

Case study analyses on epilepsy

A married man aged 25 had an historical background of the occurrences of complex partial seizures in his lifetime. He was therefore diagnosed on epilepsy after continuous occurrences of seizures. This paper therefore is the analysis of the data on how the diagnoses to this health problem were done. These are actual diagnoses in reference to NANDA nursing diagnosis which were considered, the nursing interventions (NIC) and the nursing outcomes (NOC). Actual diagnoses are the client’s health problems which are confirmed to be present during the nursing assessment period. The present indications and symptoms are important in the actual diagnoses as well as the historical background (Carpenito-Moyet, 2008).

Diagnoses considered

There were different NANDA diagnoses that were considered by me as the attending nurse when the man came to seek for the medical attention. The first diagnosis was on simple partial seizures. The man had explained that he had been experiencing these types of seizures from his childhood. This gave a go ahead to this type of diagnoses where the sighs and symptoms of simple partial seizures were examined and confirmed thus the diagnosis was eventually accepted. There were also the diagnoses of the complex partial diagnoses. The client insisted on this kind of diagnoses since he had been experiencing these types of seizures. I however thought that since the results of the simple partial seizures were positive there was no need of carrying the diagnoses. I however did the diagnoses of which the results were positive that led to the acceptance of the diagnoses. The results increased my suspicion and I thought on carrying another diagnoses on tonic-clonic seizure. Many of the signs and symptoms were also present which lead to the acceptance of the diagnoses.

There are different signs and symptoms of the three diagnoses that were carried. In these diagnoses the outcomes and the interventions in reference to the diagnoses are also different. The following discussion is an inclusive of the three diagnoses that we agreed upon with my client with their specific outcomes and interventions.

Simple partial seizures

Simple partial seizures are characterized by different types of symptoms and signs. There are: motor signs, state of awareness in the conscious mood, sensory and psychic signs, and symptoms. The client explained from his historical occurrences of seizures what he undergoes through during this period. During the time of our discussion, the seizures reoccurred which lead to better understanding of the seizures. The motor signs are characterized by the irregular contraction and the muscle relaxation (Carpenito-Moyet, 2008). At this state one turns his head in one side and there are a lot of eye movements. He could not speak due to the speech arrest and the act of asymmetrical positioning of his limbs.

Sensory symptoms are also present at the state of seizures. He said that he always sees the flashes of different colors of false impressions and hallucinations. There are unpleasant odors which he always experiences and tastes. He complained of dizziness and hearing humming and hissing noises. There were involuntary activities which were present especially every time when seizures reoccurred of which some of them were evidenced at the time of our discussion. He always experiences a lot of sweating while when I examined him, the heart rate was so rapid. There were also reverberating noises which were produced in his intestines. He also complained of vomiting and flushing.

Psychic symptoms are also present in the occurrence of simple partial seizures. He explained that he always feel depressed and experiences a lot of fear that he cannot explain where it is coming from. When he gains the normal consciousness he always feels as if he had been dreaming but he is always in a position to recall the past episodes very fast. There are different outcomes in relation to simple partial seizures –NOCs. The NOCs are subdivided into three categories-the risk detection, risk control, and knowledge on personal safety (Boyd, 2008).

On the NOC outcomes I explained the presumed causes for the simple seizure. Poor health like alcohol taking and caffeine are some of the possible cause. Irregular follow up of the clinical check up also causes seizures as there is no regular monitoring of the problem, he explained that he only visit the medical check up only when the seizures reoccurs. Missed doses in many cases also cause the seizures. From the case study the client confirmed having missed to take his doses when he was away during the night (Kyle & Terri, 2007).

On the NIC interventions we discussed the significance of upholding good health. The client had already involved in alcohol taking which is not good to his health and also having some good time to rest which is inclusive of sleeping well. I also advised the need for the regular follow up to the health clinic as indicated. We also reviewed together the medication regimen and advised the need of taking the drugs as prescribed and incase of any discontinuation then I as his attending nurse, I should be notified immediately. Upon forgetting the time for taking these medicines, then the client should take them immediately when he remembers and be keen to observe enough time before the next dosage taking to avoid overdose (Boyd, 2008).

Complex partial seizures

In complex partial seizure there are always occurrences of unconsciousness to the patient. The client had reported to the nurse of his historical occurrences of seizure where upon him insisting on the diagnoses then I found the importance of carrying it. During the unconsciousness the man explained that he always has a frighten look as them that are around him always inform him when he regains his consciousness. During his unconscious state the man explained that he sometimes runs away and start wandering such that when he regains his consciousness he always find him self in a different environment especially when the seizures occurs when he is alone and nobody to control his movements (Carpenito-Moyet, 2008).

He also explained that out of the increased salvation he always wet his shirt since he cannot keep the saliva in his mouth. The fact is at this time he may not be in a position to control anything and when his mouth is open, the saliva just flows out the mouth. He also expresses some sexual gestures in that when he is informed on what he was doing after the regain of consciousness he feels embarrassed. Sometimes he even cries with a loud voice but still being unconscious as though something wrong or a certain fear has been inflicted to him. It is even worse since now he experiences some drop attacks. When this happens he always losses the positional tone and always fall suddenly with an onset unconsciousness. When he suddenly falls he is some time hurt especially at the head if he happens to fall on a hard ground or material.

On NOC outcome, flashing lights and quire video games had a lot of impact in reference to his health. After watching terrifying video game for a long time he always finds himself after sometimes developing these kinds of seizures. At the state of the unconsciousness the client finds himself biting or even sudden falling especially if there were no initial signs to show the occurrence of the seizure. The client has many times been choked by chewing gum thus developing seizures. At these times he always finds a lot of difficulties in his breathing (Carpenito-Moyet, 2008).

NIC interventions regarding the quire videos and flashing lights, I advised him on why he should avoid such. The fact is these are conditions that can be easily be managed just by a normal lifestyle. To avoid biting himself the nearest care take should always insert a block into his mouth only if the jaw well relaxed. When he just suddenly fall he should then be placed in a well lying area and if he was just warming himself then it is most advisable to move him into a cool place ensuring proper air ventilation. I also advised the client to avoid suckling lozenges and anything that can promote choking like chewing gums especially when the seizures occur without any pre-sign (Kyle & Terri, 2007). Since there are many things which normally happen in the unconscious state I advised him not to mind on any quire behavior that he might exhibit at this state after all it is not something that he can be able to control. He should also wear protective devices especially when there are signs of the occurrences of these seizures like the head gears

Tonic-clonic seizure

During these types of seizures the client always remembers the tonic phase even though he was unconscious. These types of seizures may be confused with just simple partial seizures or complex ones since they begin showing the signs and symptoms related to them. Out of the physical examination of other parts of the body I realized that the bladder pressure always increases during this phase. This was through bladder examination where he also explained that sometimes he urinates on himself. Sometime he bites his cheek when he is unconscious or the tongue and lip. When this happens he is left with sores and wounds for many times.

He sometimes produces an energized cry which is referred to as the tonic cry or yells very loudly. At this state there is always clenching of his fingers and also the jaws. He always falls due to the state of unconsciousness. There are some sudden movements which occur of muscles in the unconscious state and when he awakens he always feels confused and sometimes he falls into a deep sleep (Boyd, 2008). He however feels tired and being weak out of the jerking movements which results from the relaxation of the muscles thus the occurrences of the muscle tones.

On the NOC we also explored on the self esteem which is created especially when the client gains the consciousness. In many cases when the client happen to urinate on himself when he gains the consciousness he feels guilt and shame. Depression due to the change of responsibility also played a big role which even had led him to drinking of alcohol. It was all about a change of role as a man in the family. The state of one not being in a position to control him self on whatever he is doing is also a very depressing state. At the state unconsciousness or shortly after regaining of consciousness the patient always portrays the contrary behaviors regarding on what he is being told to do. He is always left helpless especially when people who are around him feel that he should not be carrying some of activities even when he feels that he should, for instance climbing a tree which lowered much of his self esteem. He feels embarrassed out of the yelling that he does by the fact that he remembers the phase even though in the unconscious state (Kyle & Terri, 2007).

NIC intervention to deal with the self esteem in this case I focused on the optimistic positive aspect which helped to discard the quilt in that the patient was able to accept the condition at the same time appreciating himself. I also helped him to understand that he may not be able to carry on the responsibility as a father in the family just as expected from the society. His wife was very supportive in that she could do all that was needed to support the family financially and giving psychological support. The care givers and all those around him should understand him at the stake and try to offer necessary assistance needed. By not denying him chances of carrying responsibilities if the need arises or when he want to enjoy himself, for instance when climbing a tree or a ladder, he should then be supervised. This promotes more of his self esteem by exercising the responsibilities whereas advising him not to mind concerning anything that happens under the attack like loud yelling (Boyd, 2008).

Conclusion

Working in a partnership with consumers can positively affect the quality of nursing care in different ways. Through partnering with the consumer one is able to get the historical information or background concerning a certain heath problem. In case of epilepsy of seizures historical information is very important before choosing the type of diagnoses one is to administer. It also promotes the better communication between the consumer and the nurse where the consumer’s interests are also considered. In the data analysis of the case study above, the consumer who is referred in this case as the patient insisted on being diagnosed on the complex partial seizures of which after the diagnoses the results were positive. This led to my anxiousness and when I carried out the diagnoses on tonic-clonic seizure, the results were also positive thus the promotion of better medication-it was all promoted through partnering with the consumer. A better room is created for the consumer to receive the right advice and counseling from the nurse and being able to practice it (Boyd, 2008).

Reference

Boyd, M. (2008). Psychiatric nursing: contemporary practice. New York: Lippincott Williams & Wilkins.

Carpenito-Moyet, L. (2008). Nursing care plans & documentation: nursing diagnoses and collaborative problems. New York: Lippincott Williams & Wilkins.

Kyle, T. & Terri, K. (2007). Essentials of pediatric nursing. New York: Lippincott Williams & Wilkins.

You cannot copy content of this page