D.Y.

PATIL COLLEGE OF NURSING

KADAMWADI, KOLHAPUR
SUBJECT: CHILD HEALTH NURSING
CASE PRESENTATION ON TYPE 1 DIABETES MELLITUS
SUBMITTED TO,

MRS.JANKI SHINDE

.PROF.DEPARTMENT OF

CHILD HEALTH NURSING

D.Y.PATIL COLLEGE OF NURSING,

KOLHAPUR.

SUBMITTED BY,

MRS.ANUPRIYA NAND

MSC NSG 1ST YEAR STUDENT

CHILD HEALTH NURSING DEPARTMENT.

SUBMITTED ON :
 D.Y.PATIL COLLEGE OF NURSING
KADAMWADI,KOLHAPUR
SUBJECT:CHILD HEALTH NURSING
MARKS:20
Q.1.LONG ANSWER TYPE QUESTION
1 DEFINE EPILEPSY AND THEIR CAUSES.
2.DESCRIBE THE PATHOPYSIOLOGY OF EPILEPSY.
3.CLASSIFY THE TYPES OF EPILEPSY.
4. EXPLAIN IN DEATIL MANAGEMENT OF EPILEPSY.

ASSIGNMENT:
1.WRITE DOWN THE BRIFE EMERGENCY MANAGEMENT OF CHILD WITH EPILEPSY.
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1. 2 min Self introduction SELF INTRODUCTION ------------------ --------------- ---------- ---------------------
Myself Mrs.AnupriyaNand -

from MSc.(N)1st year, Child Health Nursing

department, as a part of our curriculum, for
that today I will be engaging your class.

2. 2 min Topic introduction Introduction: Explaining Listening ------------ ---------------------

Epilepsy is a disorder in which a person has
repeated seizures. Epilepsy are abnormal
involuntary motor, autonomic resulting from
abnormal electrical discharges from the
brain.

3 2 min Define epilepsy Definition : Explaining Listening Roller Students defined

Epilepsy is characterized by recurrent, and writing Board epilepsy.
episodic, paroxysmal, involuntary clinical notes
events associated with abnormal electrical
activity from the neurons.
4. 3 min Enlist the causes of Causes of epilepsy: Explaining Listening Chart Students enlisted
epilepsy  Vascular Malformation and asking and writing the causes of
 Infection questions. notes and epilepsy.
 Trauma ‘’Name any answering
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 Alzheimer’s infections of questions.
 Metabolic derangements brain.’’
 Idiopathic
 Neoplasm
 Psychiatric

Explain the PATHOPHYSIOLOGY:

5. 5min pathophysiolo-gy Explaining Listening Black Students
of epilepsy Abnormalities in ion channel and writing board explained the
( Na+, K+, Ca+ ) notes pathophysiology
(or) of epilepsy.
Decreased INT activity /
inactivation of INT activity

Increased ENT activity

Rhythmic & repetitive hypersynchronus

discharge of neurons
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Seizures focus

Seizures

Repeated seizures

Epilepsy

6. 7 min Discuss brief about CLASSIFICATION OF EPILEPSY OR Explaining Listening P Students

classification and SEIZURE: and writing P Discussed briefly
manifestation of A) Partial seizure/ Focal notes T about
epilepsy 1.simple partial. classificationand
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2.complex partial. manifestation of
epilepsy.
B)Generalized seizure
1.Absence seizure/petit mal
2.Tonic- Clonic seizure/Grand-mal
3.Myoclonic seizure
4. Atonic seizures

C) Unclassified
Neonatal seizure

D) Status Epilepticus

A) Partial seizure:
 Partial seizure is cause due to the
abnormal discharge from small
portion of brain.
 it affect only on one hemisphere. It
dived into two types that are.
1.simple partial seizure:
Seizure does not affect the awareness, which
affect the muscle of the body.
2.complex partial seizure:
 It affect awareness or memory of
events before, during and
immediately after seizure.
 symptoms are, muscle contraction,
one side of the body is affected.
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Abdominal pain, dilated pupils.
B) Generalized seizure:
Its involve abnormal electrical discharge
from both cerebral hemisphere. It dived
into two types that are:
1.Absence generalized seizure:
 It involve disturbance in the brain
function.
 seizure are last less than 15 sec.
during this seizure child stop
walking and start again a few
second.

2.Genralized tonic-clonic seizure

(Grandmal seizure):
They can occur at any age. The child loses
consciousness suddenly and falls on the
ground.
Tonic seizure:
 it is initial phase of seizure
 which consists intense muscle
contraction, abdomen and chest
become rigid and pallor, pupils get
dilated, the neck and leg get flexed.
Clonic phase:
 in this phase jerking movement are
produced as result of contraction and
relaxation of muscles.
 it can last from 30 sec to 30
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min.2.Myoclonic seizure:
 This seizure occurs in infants usually
between 3 to 8 month age .
 It associated with cerebral
abnormalities and mental
retardation.
 Sudden myoclonic contraction of
trunk, neck and extremities.
 The duration is last usually less than
one min.

3.Myoclonic seizure:

 This seizure occurs in infants usually

between 3 to 8 month age .
 It associated with cerebral
abnormalities and mental
retardation.
 Sudden myoclonic contraction of
trunk, neck and extremities.
 The duration is last usually less than
one min.

4.Atonic seizure:
 (DROP ATTACKS): Sudden
loss of postural tone,
 patient falls to the ground
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 Occur primarily in children

C. UNCLASSIFIED SEIZURE:

1.Neonatal seizure:
 its are epileptic fits occurring from
birth to the end of the neonatal
period.
 The neonatal period is the most
vulnerable of all periods of life for
developing seizure.
 Its occur due to the malfunction or
damage of immature brain.

D. Status epilepticus:
Seizure occur repeatedly with no recovery
of consciousness between attacks.

Enlist the DIAGNOSTIC EVALUATION:

diagnosticevaluatio  History collection.
7. 3 min n of epilepsy  EEG Explaining Listening Black Students enlisted
and asking and writing board the diagnostic
 Computed axial tomography
questions. notes. evaluation of
 Magnetic resonance imaging.
epilepsy.
 Complete blood count ‘what is the
 Positron emission tomography full form of
EEG?’’
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8 10 Discuss the MANAGEMENT: Explaining Listening Pamplets Students

min management of and writing discussed the
epilepsy. 1.MEDICAL MANAGEMENT: notes management of
epilepsy.
Drug Indication Dose
carbamazepin Partial,toni 400mg//da
e c y
clonic
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Phenytoin Tonic 3-5mg/kg

clonic /day

clonazepam Absence 1.5mg/

seziure kg/day
Clobazam partial 0.3-2mg/
kg/day
phenobarbito Tonic- 1-3mg/kg
ne clonic /day

2.SURGICAL MANAGEMENT:
Neurosurgery may done in case of
uncontrolled seizure. Surgery is done for
removal of tumors, hematomas, scar and
other brain infection.
Eg. lobe resection, vagus nerve stimulation

3. NURSING MANAGEMENT:
Its include emergency care
 Assist the child to a lying position.
 Take off eye glasses, if child wears
and loosen the tight clothes.
 Remove dangerous object from
child.
 Maintain patent airway and adequate
oxygenation
 Administer the prescribed
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medication
 Do not restrain the child during
seizure.
 Do not force anything into the
child’s mouth during seizure.
Care of child after seizure:
 The child should provide complete
bed rest.
 Change the clothes and bed sheet if
soiled.
 Suction the airway .
 Observe the child until
fullyconscious.
 Treat any injury occurred during
seizure.
 Continuously monitor child vital
signs.

SUMMARY:
So as far we discussed about the definition,
causes,
pathophysiology,classification,clinical
manifestation, diagnostic evaluation,
medical, surgical and nursing management
for epilepsy.
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------------
-
9 2 min Conclusion CONCLUSION: ------------------ --------------- ------------ ---------------------
Here I conclude that epilepsy common - - - -
occur in the child which can manage with
treatment and emergency care to the child.
LESSON PLAN

Student teacher:Mrs. AnupriyaNand

Programme: B.Sc Nursing
Subject: Child Health Nursing
Topic: Epilepsy
Method of teaching: lecture cum discussion
Medium of instruction: English
Group: 3rd year
No. of students: 50
Venue:3rd year Classroom
Date: 13-01-2020
Time: 2-3 pm
Name of the evaluator:Prof Mrs. JanakiShinde
Teaching aids: Blackboard, Roller board, PPT, Chart,Pamplets.
Previous knowledge of students: students may have some knowledge Epilepsy.
GENERAL OBJECTIVES:
At the end of the class, students will be able to gain adequate knowledge regarding Epilepsy
and its management and apply this knowledge in both clinical and education settings.

SPECIFIC OBJECTIVES:
At the end of the class, students will be able to:
1. Define the Epilepsy
2. Enlist the causes of Epilepsy
3. Describe the pathophysiology of Epilepsy.
4. Discuss the classification and manifestation of Epilepsy.
5. Explain the diagnostic evaluation of Epilepsy.
6. Discuss the Medical, Surgical and Nursing management of Epilepsy.

BIBLIOGRAPHY

1.Sudhakar A. Essentials of pediatric nursing. Uttar Pradesh: jaypee brothers medical

publications;2008.

2.Datta P. Pediatric nursing. West bengal: jaypee brothers medical publications;2003.

3.Sharma R. Essentials of pediatric nursing. Punjab: jaypee brothers medical

publications;2000.
3. NURSING MANAGEMENT: 3. NURSING MANAGEMENT:
Its include emergency care Its include emergency care
 Assist the child to a lying position.  Assist the child to a lying position.
 Take off eye glasses, if child wears and  Take off eye glasses, if child wears and
loosen the tight clothes. loosen the tight clothes.
 Remove dangerous object from child.  Remove dangerous object from child.
 Maintain patent airway and adequate  Maintain patent airway and adequate
oxygenation oxygenation
 Administer the prescribed medication  Administer the prescribed medication
 Do not restrain the child during seizure.  Do not restrain the child during seizure.
 Do not force anything into the child’s  Do not force anything into the child’s
mouth during seizure. mouth during seizure.

Care of child after seizure: Care of child after seizure:

 The child should provide complete bed rest.  The child should provide complete bed rest.
 Change the clothes and bed sheet if soiled.  Change the clothes and bed sheet if soiled.
 Suction the airway .  Suction the airway .
 Observe the child until fullyconscious.  Observe the child until fullyconscious.
 Treat any injury occurred during seizure.  Treat any injury occurred during seizure.
 Continuously monitor child vital signs.  Continuously monitor child vital signs.

3. NURSING MANAGEMENT: 3. NURSING MANAGEMENT:

Its include emergency care Its include emergency care
 Assist the child to a lying position.  Assist the child to a lying position.
 Take off eye glasses, if child wears and  Take off eye glasses, if child wears and
loosen the tight clothes. loosen the tight clothes.
 Remove dangerous object from child.  Remove dangerous object from child.
 Maintain patent airway and adequate  Maintain patent airway and adequate
oxygenation oxygenation
 Administer the prescribed medication  Administer the prescribed medication
 Do not restrain the child during seizure.  Do not restrain the child during seizure.
 Do not force anything into the child’s  Do not force anything into the child’s
mouth during seizure. mouth during seizure.

Care of child after seizure: Care of child after seizure:

 The child should provide complete bed rest.  The child should provide complete bed rest.
 Change the clothes and bed sheet if soiled.  Change the clothes and bed sheet if soiled.
 Suction the airway .  Suction the airway .
 Observe the child until fullyconscious.  Observe the child until fullyconscious.
 Treat any injury occurred during seizure.  Treat any injury occurred during seizure.
 Continuously monitor child vital signs.  Continuously monitor child vital signs.

PATHOPHYSIOLOGY:
 Abnormalities in ion channel ( Na+, K+, Ca+ )

(or) Decreased INT activity / inactivation of INT activity

Increased ENT activity 

Rhythmic & repetitive hypersynchronus discharge of neurons

Seizures focus

Seizures

Repeated seizures

Epilepsy

MANAGEMENT: MANAGEMENT:
1.MEDICAL MANAGEMENT: 1.MEDICAL MANAGEMENT:

Drug Indication Dose Drug Indication Dose

carbamazepine Partial,tonic 400mg/kg/day carbamazepine Partial,tonic 400mg/kg/day
clonic clonic

Phenytoin Tonic clonic 3-5mg/kg Phenytoin Tonic clonic 3-5mg/kg

/day /day
clonazepam Absence 1.5mg/ clonazepam Absence 1.5mg/
seziure kg/day seziure kg/day
Clobazam partial 0.3-2mg/ Clobazam partial 0.3-2mg/
kg/day kg/day
phenobarbitone Tonic-clonic 1-3mg/kg phenobarbitone Tonic-clonic 1-3/kg
/day /day

2.SURGICAL MANAGEMENT: 2.SURGICAL MANAGEMENT:

Neurosurgery may done in case of uncontrolled seizure. Neurosurgery may done in case of uncontrolled seizure.
Surgery is done for removal of tumors, hematomas, scar and Surgery is done for removal of tumors, hematomas, scar and
other brain infection. other brain infection.
Eg. lobe resection, vagus nerve stimulation Eg. lobe resection, vagus nerve stimulation

3. NURSING MANAGEMENT: 3. NURSING MANAGEMENT:

Its include emergency care Its include emergency care
 Assist the child to a lying position.  Assist the child to a lying position.
 Take off eye glasses, if child wears and loosen the  Take off eye glasses, if child wears and loosen the
tight clothes. tight clothes.
 Remove dangerous object from child.  Remove dangerous object from child.
 Maintain patent airway and adequate oxygenation  Maintain patent airway and adequate oxygenation
 Administer the prescribed medication  Administer the prescribed medication
 Do not restrain the child during seizure.  Do not restrain the child during seizure.
 Do not force anything into the child’s mouth during  Do not force anything into the child’s mouth during
seizure. seizure.
Care of child after seizure: Care of child after seizure:
 The child should provide complete bed rest.  The child should provide complete bed rest.
 Change the clothes and bed sheet if soiled.  Change the clothes and bed sheet if soiled.
 Suction the airway .  Suction the airway .
 Observe the child until fullyconscious.  Observe the child until fullyconscious.
 Treat any injury occurred during seizure.  Treat any injury occurred during seizure.
 Continuously monitor child vital signs.  Continuously monitor child vital signs.