Nursing Assessment for Epilepsy - ABCDE
In the ictal phase, the client usually found clenched his teeth so that obstruct the airway, the client bite the tongue, mouth foaming, and the postictal phase, usually found injury to the tongue and gums due to the bite.
In the ictal phase, the client breathing down / speed, increased mucus secretion, and skin was pale even cyanosis. In phase posiktal, clients have apnea.
In the ictal phase pulse and cyanosis increase, the client usually unconscious.
Clients can be realized or not depends on the type of attacks or characteristics of epilepsy suffered. Usually the patient was confused, and do not remember the incident when the seizures.
Client's clothing was opened to thoracic examination, whether there are additional injuries due to seizures.
Nursing Diagnosis for Epilepsy
Nursing Diagnosis and Interventions Risk for Injury - Seizures
Nursing Care Plan Epilepsy Nursing Assessment Nursing Assessment for Epilepsy - ABCDE Nursing Assessment for Epilepsy - ABCDE
Abdominal Tumor Acromegaly Alzheimer's Disease Anemia Angina Pectoris Appendicitis Asthma Biliary Atresia Bronchopneumonia Cellulitis Cesarean Section CHF Chronic Kidney Disease Chronic Pancreatitis Colon Cancer Colostomy Constipation COPD Cystic Fibrosis Cystitis Dengue Hemorrhagic Fever Diabetes Diabetic Ulcers Diarrhea Down's Syndrome Dyslipidemia Encephalitis Epilepsy Filariasis Gastritis Gastrostomy Gigantism Glaucoma Hallucinations Heart Attack Heart Disease Hemophilia Hemorrhoids Hepatitis Hirschsprung's Disease Hydrocephalus Hypertension Hyperthermia Hyperthyroidism Hypospadias Hypothyroidism Impetigo Kwashiorkor Leptospirosis Leukemia Low Back Pain Marasmus Measles Myocardial Infarction Obesity Osteomyelitis Parkinson's Disease Patent Ductus Arteriosus Peptic Ulcer Perichondritis Peritonitis Pheochromocytoma Pleural Effusion Preeclampsia Pyelonephritis Rheumatoid Arthritis Schizophrenia STEMI Tongue Cancer Tuberculosis Urethral Stricture
Activity Intolerance Acute Pain Altered Family Processes Anxiety Constipation Decreased Cardiac Output Deficient Fluid Volume Deficient Knowledge Disturbed Sensory Perception Imbalanced Nutrition: Less Than Body Requirements Impaired Gas Exchange Impaired Physical Mobility Impaired Skin Integrity Impaired Social Interaction Impaired Urinary Elimination Ineffective Airway Clearance Ineffective Cerebral Tissue Perfusion Ineffective Tissue Perfusion Knowledge Deficit Low Self-esteem Risk for Decreased Cardiac Output Risk for Fluid Volume Deficit Risk for Infection Risk for Injury Risk for Social Isolation Self-care deficit Self-concept Disturbance Social Isolation