Nursing Monthly Summary for a Child With Epilepsy, Essay Example

Introduction

Jamie is a typical 11 year old boy. Visually, one can infer that his is well nourished and properly taken care of.  He tends to display hyperactivity and has difficulty following directions. Jamie is five feet tall and weighs approximately 102 pounds. He lives with his mother, father, and younger sister. Jamie has been suffering from seizures for the past three years. During my observation, Jamie typically encountered between five and six during the day, and between five and fourteen during the night. Oddly, Jamie’s seizures are more often and more severe during the night hours. Seizures that occur at night are usually characterized by the cessation of breathing from between ten seconds and a minute and a half. The most peculiar aspect of Jamie’s seizures is the fact that he seems to be able to predict when they will occur. Often, Jamie is able to ask for help seconds before the seizure begins. Directly before a seizure, Jamie’s pupils are enlarged and he has problems focusing on people or objects. On several occasions he has unintentionally stumbled over furniture and on other occasions he merely falls to the floor unable to control his body movements. During these episodes, Jamie’s body shakes and jerks violently, his eyes are fixated, but he still blinks-sometimes he eyes will roll behind his lids; he loses control of his bowels and bladder, and he drools and/or foams from the mouth. At the cessation of the seizure, Jamie is clearly extremely tired and confused.

Nurse Intervention

“The role of the advanced practice nurse in pediatric epilepsy is to care for the child and his or her family. Advanced practice nurses are often responsible for diagnosing epilepsy and managing care of children with epilepsy and their families”(McNelis, Buelow, Myers, &Johnson, 2007).The nurse must be very observant of the patient. Safety measures must be taken if there is an indication that the patient is about to experience a seizure. The patient should be moved into a laying down position, preferably on the side to prevent choking. Also, be observant if certain activities may be triggering seizures. Because Jamie’s seizures are more severe during the night hours, his bed should remain in a low position with the side-rails up and padded to prevent an injury due to falls. Each time the patient experiences a seizure, the date, time, and duration of the seizure should be documented. Also, make note of Jamie’s level of consciousness. Soon after the seizure, please record the type of motor activity that was displayed. For example, clonic(jerking), myclonic(single jerk of muscle), tonic(stiffening), abnormal movements, dystonia, eye deviation, open, rolling or closed, eye lids flickering, head turning, and/or twitching.  Any changes in respiration, heart rhythm, skin changes (Elliot, Lach, & Smith, 2005). During the seizure it is important to ensure the patient has adequate ventilation. Clothes should be loosened and free of restraints; however, never force an airway or tongue blade through clenched teeth. Do not restrain movement during the seizure; just ensure that the patient is away from objects that can harm him. When possible, break the fall by easing them to the floor. It has been documented that some patients are able to hear during unconscious states, so verbal reassurances can aid the person in regaining consciousness.

Cooping

Several studies have been conducted to determine the psychological strain family members endure when handling a child with epilepsy.  It has also been documented that children with epilepsy “ have lower self-esteem, higher rates of depression, and increased behavior troubles in comparison to children not suffering from a neurologic condition” ( Mims, 1997 ). The families of children with this disorder play a significant role the child’s ability to cope with the disorder. When family members treat the child differently from other members of the family, it makes it very difficult for the child to adapt to the illness.  In 2008, a study was conducted to determine how the siblings of children with epilepsy are affected by the illness. The results concluded that of the thirty-seven families surveyed, about twenty-five percent of the siblings had anxiety about their sibling suffering from the illness. However, nearly 72 percent of parents had anxiety. So, researchers concluded that parents are more psychologically affected by their children illnesses than are their siblings.  Twenty-five percent were moderately to severely depressed, and 67 percent had sleep disturbances (Chiou& Hsieh, 2008   ). Consequently, many epileptic nurses help parents implement or get involved with psycho-educational programs that provide resources and ways to cope with the child’s condition, as well as helping siblings function when dealing with the members’ chronic illness. These meeting may be held for single families or multifamily. Sometimes they are in the lecture format, while other times it may take place in the small group setting. The participants learn about treatment of the condition through proper diet and medication in hopes of increasing quality of life and decreasing epilepsy frequency (Elliot, Lach, & Smith, 2005).

Conclusions

About 2.5 million Americans are affected by epilepsy (Elliot, Lach, & Smith, 2005). Nurses help families effectively cope with the illness by decreasing anxiety through coping strategies and increasing the quality of life for all individuals affected by the disorder.The Family Stress and Coping Theory states that families have the ability to cope under stress, but that stress can increase to a level where coping becomes impossible. Consequently, family members of children with epilepsy must be sensitive to the negative psychosocial effects of epilepsy.Proper intervention will ensure that families do not reach high levels of stress which negatively affects the children suffering from the disorder.

References

Chiou, H. & Hsieh, L. (2008). Comparative study of children’s self-concepts and parenting stress between families of children with epilepsy and asthma. Journal of Nursing Research, 16, 65-73.

Elliot, I., Lach, L., & Smith, M. (2005). Epilepsy: Impact on the life of a child. Epilepsy Canada, 4, 4-6.

McNelis, A., Buelow, J., Myers, J., & Johnson, E. (2007). Concerns and needs of children with epilepsy and their parents. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 21, 195-202

Mims, J. (1997). Self esteem, behavior, and concerns surrounding epilepsy in sibling of children with epilepsy. Journal of Child Neurology, 12, 187-192.