Nursing Key Outcomes, Nursing Interventions, Patient Teaching For Epilepsy

Common nursing diagnosis found in nursing care plans for Epilepsy, Ineffective airway clearance, Anxiety, Deficient knowledge (diagnosis and treatment), Fear, Ineffective coping, Risk for injury, Social isolation

Nursing Key outcomes nursing care plans for Epilepsy
Patients with epilepsy will:

• Express feelings of decreased anxiety.
• Communicate an understanding of the condition and treatment regimen.
• Identify any fears or concerns.
• Use support systems and develop adequate coping.
• Remain free from injury.
• Resume active participation in social situations and activities.
• Family will use support systems and develop adequate coping

Nursing interventions nursing care plans for Epilepsy

• Provide emotional support to patients.
• Encourage patient express their fears and concerns. Suggest counseling to help them cope.
• Encourage family express their fears and concerns, and sugest to support counseling to help them cope.
• Monitor the patient for signs and symptoms of toxicity, such as slurred speech, ataxia, lethargy, dizziness, drowsiness, nystagmus, irritability, nausea, and vomiting. If the patient is taking anticonvulsants
• If needed Prepare the patient for surgery.
• If necessary, provide preoperative and postoperative care appropriate for the type of surgery the patient is to undergo.

Patient Teaching Discharge And Home Healthcare Guidelines

Be sure that the patient understands all medications, including the dosage, route, action,adverse effects, and need for routine laboratory monitoring of AEDs

• Give adequate patient support by developing an understanding of, Answer of any patients questions.
• Teach patients dispelling myths. For example, assure them that epilepsy is not contagious and is controllable for most patients who follow a prescribed regimen of medication. Provide assurance that most patients maintain a normal lifestyle.
• Explain to the patient and his family the need for compliance with the prescribed drug schedule.
• Assure the patient that anticonvulsant drugs are safe when taken as ordered..
• Teach the patient about the medication's possible adverse effect drowsiness, lethargy, hyperactivity, confusion, visual and sleep disturbance all of which indicate the need for dosage adjustment. Tell him that phenytoin therapy may lead to hyperplasia of the gums, which may be relieved by conscientious oral hygiene. Instruct the patient to report adverse reactions immediately.
• Explain the importance of having anticonvulsant blood levels checked at regular intervals even if the seizures are under control.
• Instruct the patient to eat regular meals and to check with his physician before dieting. Explain that maintaining adequate glucose levels provides the necessary energy for central nervous system neurons to work normally. (See Preventing seizures.)
• If the patient is needs  surgery, provide appropriate preoperative teaching. Explain the care that the patient can expect postoperatively.
• Teach the patient's family to Avoid restraining the patient during a seizure
• Know which social agencies in your community can help epileptic patients. Refer the patient to the Epilepsy Foundation for general information and to the state motor vehicle department for information about a driver's license.

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Nursing Key outcomes, Nursing interventions, and patient teaching Nursing Care Plans for Chronic Renal Failure

Nursing Key outcomes, Nursing interventions, and patient teaching Nursing Care Plans for Chronic Renal Failure
Key outcome for patients with CRF, patients will:

• Report increased comfort.
• Maintain hemodynamic status.
• Remain oriented to person, place, time, and situation.
• Maintain fluid balance.
• Verbalize appropriate food choices according to his prescribed diet.
• Maintain adequate ventilation and oxygenation.
• Demonstrate skill in managing the urinary elimination problem.
• Use support resources and exhibit adaptive coping behaviors.
• Resume sexual activity to the fullest extent possible.
• Maintain adequate urine output.
• Verbalize having feelings of control over condition and own well-being.
• Remain free from signs or symptoms of infection.
• Avoid or minimize complications.
• Family members will demonstrate adaptive coping behaviors.
• The patient's oral mucous membrane will remain intact.
• Family members will verbalize the effects of the patient's condition on the family unit.

Nursing interventions Nursing Care Plans for Chronic Renal Failure (CRF)
The widespread clinical effects of chronic renal failure require meticulous and carefully coordinated supportive care.

• Provide good skin care.
• Provide good oral hygiene
• Offer small, palatable, nutritious meals
• Monitor the patient for hyperkalemia. Watch for cramping of the legs and abdomen and for diarrhea.
• Carefully assess the patient's hydration status.
• Carefully measure daily intake and output.
• Monitor for complications.
• Encourage the patient to perform deep-breathing and coughing exercises to prevent pulmonary congestion
• Maintain aseptic technique.
• Carefully observe and document seizure activity. Periodically assess neurologic status.
• Observe for signs of bleeding.
• Report signs of pericarditis, such as a pericardial friction rub and chest pain.
• Schedule medication administration carefully.
• If the patient requires dialysis, check the vascular access site for patency and the arm used for adequate blood supply and intact nerve function.
• After dialysis, check for disequilibrium syndrome, a result of sudden correction of blood chemistry abnormalities.

Patient teaching Nursing Care Plans for Chronic Renal Failure (CRF)

CRF and ESRD are disorders that affect the patient’s total lifestyle and the whole family. Patient teaching is essential and should be understood by the patient. All teaching should be reinforced at intervals during the patient’s lifetime. Include: Care of peritoneal catheter for dialysis, care of external arteriovenous dialysis access (shunt), care of the arteriovenous fistula, post-transplantation teaching.

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Nursing Outcomes Nursing interventions and Patient teaching Nursing care plans for Conduct Disorder

Nursing outcomes Nursing care plans for Conduct Disorder

• Patients Anxiety is maintained at a level at which client feels no need for aggression and will not harm self or others physically or emotionally.
• Client will seeks out staff to discuss true feelings.
• Client recognizes, verbalizes, and accepts possible consequences of own maladaptive behaviors.
• The patient and parents will attend counseling to discuss the patient's illness and learn how to handle his behavior.
• Patient will develop effective coping skills to help him process stressors.
• Patient will develop effective social interaction and problem solving skills.
• Patient will utilize constructive channels to release anger.
• Patient will express awareness of how his actions affect others.

Nursing interventions Nursing care plans for Conduct Disorder

Work to establish a trusting relationship with the child. Provide clear behavioral guidelines, including consequences for disruptive and manipulative behavior. Help the child accept responsibility for behavior rather than blaming others, becoming defensive, and wanting revenge.

Nursing Diagnosis and Interventions for Conduct Disorder


Patient teaching Nursing care plans for Conduct Disorder

• Teach the child effective coping skills, social skills, and problem-solving skills, and have him demonstrate them in return.
• Teach the child to express anger appropriately through constructive methods to release negative feelings and frustrations.
• Use role playing to help the child practice handling stress and gain skill and confidence in managing difficult situations.

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Nursing Care Plans for Epilepsy

Epilepsy is a paroxysmal neurological disorder; epilepsy is a condition of the brain characterized by a susceptibility to recurrent seizures. It's also known as seizure disorder. Seizures are paroxysmal events associated with abnormal electrical discharges of neurons in the brain. In most patients, this condition doesn't affect intelligence. Epilepsy characterized by recurrent episodes of convulsive movements or other motor activity, loss of consciousness, sensory disturbances, and other behavioral abnormalities. Epilepsy often considered a syndrome rather than a disease, because epilepsy occurs in more than 50 diseases. Epilepsy usually occurs in patients younger than age 20, patients with Epilepsy achieve good seizure control with strict adherence to prescribed treatment.

Causes for Epilepsy

About half the cases of epilepsy are idiopathic. Nonidiopathic epilepsy may be caused by:

• Primary central nervous system CNS disorders include any potential mass effect (tumor, abscess, atrioventricular malformation AVM, aneurysm, or hematoma)
• Stroke (especially those that are embolic.).
• Genetic abnormalities (E.g. Tuberous sclerosis and phenylketonuria PKU)
• Prenatal injuries
• Metabolic abnormalities, such as hypocalcemia, hypoglycemia, and pyridoxine deficiency
• Brain tumors
• Infections, such as meningitis, encephalitis, or brain abscess
• Developmental disorders. Epilepsy can be associated with other developmental disorders, such as autism and Down syndrome
• Traumatic injury, especially if the dura mater was penetrated
• Toxins, such as mercury, lead, or carbon monoxide

Epilepsy occurs in all races and ethnicities, Researchers have also detected hereditary EEG abnormalities in some families, and certain seizure disorders appear to have a familial incidence. Different age groups have distinct associated causes. newborns up until 6 months of age, seizures are generally caused by birth trauma or metabolic disturbances. In children from 6 months to 5 years of age, etiology is related to febrile episodes or metabolic disturbances (hyponatremia, hypernatremia, hypoglycemia, hypocalcemia). In the 5- to 20-year-old group, seizures are primarily idiopathic (50%). In adults from 20 to 50 years of age, a new onset of seizures is almost exclusively caused by trauma or tumors. In older adults, seizures are generally caused by vascular disease cardiac dysrhythmias and Dementia.

Complications for Epilepsy
Associated complications can occur during a seizure:

• Anoxia from airway occlusion by the tongue or vomitus and
• Traumatic injury could result from a fall while the patient is confused or has an altered level of consciousness.
• Drowning

 Other life threatening complications

• Sudden unexplained death
• Status epilepticus

Nursing Assessment Nursing Care Plans for Epilepsy

Signs and symptoms vary Depending on the type and cause of the seizure. Physical findings may be normal if the assessment is performed when the patient isn't having a seizure. If the seizure is associated by a brain tumor, which may reveal signs and symptoms of that problem

Patient’s history of seizure occurrence

Diagnostic tests for Epilepsy

• Electroencephalogram EEG
• Computed tomography scanning
• magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• Other helpful tests include serum glucose and calcium studies, skull X-rays, lumbar puncture, brain scan, and cerebral angiography, Neuropsychological tests.

Treatment for Epilepsy
Specific to the type of seizure.

• commonly prescribed drugs include phenytoin, carbamazepine, phenobarbital, valproic acid, and primidone administered individually for generalized tonic-clonic seizures and complex partial seizures. Valproic acid, clonazepam, and ethosuximide are commonly prescribed for absence (petit mal) seizures. Lamotrigine is also prescribed as adjunct therapy for partial seizures. Fosphenytoin is an I.V. preparation that's effective in treatment.
• Surgical removal of a demonstrated focal lesion to attempt to end seizures
• Vagal nerve stimulation
• Transcranial magnetic stimulators

Nursing diagnosis Nursing Care Plans for Epilepsy

• Ineffective airway clearance related to clonic tonic motor activity and tongue obstruction
• Anxiety
• Deficient knowledge (diagnosis and treatment)
• Fear
• Ineffective coping
• Risk for injury
• Social isolation

Nursing Key outcomes, nursing interventions and Patient teaching Nursing Care Plans for Epilepsy

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Nursing care plans for patient’s with Delusional disorders

Psychiatric nursing care plans for Delusional disorders. Delusional disorders are characterized by false beliefs with a plausible basis in reality. Formerly referred to as paranoid disorders, delusional disorders are known to involve erotomanic, grandiose, jealous, or somatic themes as well as persecutory delusions. Some patients experience several types of delusions; other patients experience unspecified delusions that have no dominant theme. Delusional disorders typically chronic, these disorders often interfere with social and marital relationships but seldom impair intellectual or occupational functioning significantly. (DSM-IV-TR)

Delusional disorder is characterized by the presence of one or more no bizarre delusions that last for at least 1 month. Hallucinatory activity is not prominent. Apart from the delusions, behavior and functioning are not impaired. The following types are based on the predominant delusional theme (AMA, 2000):

• Persecutory
• Jealous
• Erotomanic
• Somatic
• Grandiose

Causes for Delusional disorders

Hereditary predisposition. Some researchers suggest that delusional disorders are the product of specific early childhood experiences with an authoritarian family structure. sensitive personality is particularly vulnerable to developing a delusional disorder. At least one study has linked the development of delusional disorders to inferiority feelings in the family. Certain medical conditions exaggerate the risks of delusional disorders: head injury, chronic alcoholism, deafness, and aging.

Complications for Delusional disorders

Patient’s irrational beliefs may pose a threat to him or others. Greater patient's rage, the greater the risk of violent behavior or suicide.

Treatment for Delusional disorders

• Combination of drug therapy and psychotherapy.
• Drug with antipsychotic agents is similar other psychiatric drugs, such as antidepressants and anxiolytics.

Nursing diagnoses Nursing care plans for Delusional disorders

• Risk for other-directed violence
• Risk for self-directed violence
• Social isolation
• Anxiety
• Disabled family coping
• Disturbed personal identity
• Disturbed sensory perception (visual, auditory)
• Disturbed thought processes
• Fear
• Imbalanced nutrition: Less than body requirements
• Impaired home maintenance
• Impaired social interaction
• Ineffective coping
• Powerlessness
• Risk for injury

Nursing Key outcomes nursing care plans for patient’s with Delusional disorders

• The patient will consider alternative interpretations of a situation without becoming hostile or anxious. Anxiety is maintained at a level at which client feels no need for aggression.
• Client demonstrates trust of others in his or her environment.
• Client maintains reality orientation.
• Client causes no harm to self or others.
• Client demonstrates willingness and desire to socialize with others, voluntarily attends group activities.
• Client approaches others in appropriate manner for one-to-one interaction.
• The patient and his family will participate in care and prescribed therapies.
• The patient will identify internal and external factors that trigger delusional episodes.
• The patient will maintain functioning to the fullest extent possible within the limitations of his visual or auditory impairment.
• The patient will express all fears and concerns.
• Client is able to recognize that hallucinations occur at times of extreme anxiety.
• Client is able to recognize signs of increasing anxiety and employ techniques to interrupt the response.
• The patient will demonstrate effective social interaction skills in both one-on-one and group settings.
• The patient will demonstrate adaptive coping behaviors.
• The patient will identify and perform activities that decrease delusions.
• The patient will remain free from injury.
• The patient will maintain family and peer relationships.

Nursing interventions nursing care plans for patient’s with Delusional disorders

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