Seizure

Definition:
It is a sudden alteration in normal brain activity that causes distinct changes in behavior
and body function. They are thought to result from abnormal, recurrent, uncontrolled electric
discharges of neurons in the brain. It is also known as convulsions, epileptic seizures, and if
recurrent, epilepsy.
Seizures are classified as partial or generalized by the origin of the seizure activity and
associated clinical manifestations.
a. Simple partial seizures manifest motor, somatosensory, and psychomotor symptoms
without impairment of consciousness.
b. Complex partial seizures manifest impairment of consciousness with or without
simple partial symptoms.
c. Generalized seizures manifest a loss of consciousness with convulsive or
nonconvulsive behaviors and include tonic-clonic, myoclonic, atonic, and absence
seizures.
Etiology:
Head or brain trauma, tumors, cranial surgery, metabolic disorders (hypocalcemia,
hypoglycemia or hyperglycemia, hyponatremia, anoxia); central nervous system infection;
circulating disorders; drug toxicity; drug withdrawal states (alcohol, barbiturates); and congenital
neurodegenerative disorders.
Clinical Manifestations:

Some people may experience feelings, sensations or changes in behavior hours or days
before a seizure. These feelings are generally not part of the seizure, but may warn a

person that a seizure may come.

An aura or warning is the first symptom of a seizure and is considered part of the seizure.

Dj vu (a feeling of being there before but never have)

Jamais vu (a feeling that something is very familiar but it isnt)

Unsual Smells

Unsual Sounds

Unsual Tastes

Pleasant feelings

Visual loss or blurring

Racing thoughts

Strange feelings

Dizzy or lightheaded

Headache

Fear/panic (often negative or scary

feelings)

Nausea or other stomach feelings (often a rising feeling from the stomach to the throat)

Numbness or tingling in part of the body

Loss of awareness (often called black out)

Confused, feeling spacey

Distracted, daydreaming

Periods of forgetfulness or memory

Loss of consciousness, unconscious,

lapses

or pass out

Formed visual hallucinations (objects or things are seen that arent really there)

Numbness, tingling, or electric shock

Feeling detached

like feeling in body, arm or leg

Body parts feels or looks different

Out of body sensations

Feeling of panic, fear, impending doom (intense feeling that something bad is going to
happen)

Losing control of urine or stool unexpectedly

Repeated non-purposeful movements, called automatisms

Sweating

Change in skin color (looks pale or

Biting of tongue (from teeth

clenching when muscles tighten)

flushed)

Difficulty breathing

Pupils may dilate or appear larger

Heart racing

than normal

Management (Surgical, Medical, Pharmacologic, Nursing):

Antiepileptic drugs (AEDs) may be used singly or in combination to increase

effectiveness, treat mixed seizure types, and reduce adverse effects.

Surgical treatment of brain tumor or hematoma may relieve seizures caused by these.
Temporal lobectomy, extratemporal resection, corpus callosotomy, or
hemispherectomy may be necessary in medically intractable seizure disorders.

Complications:

Injuries such as Joint dislocations,

Head injuries and Bone fractures

Repeated seizures
Falls
Drowning

Psychological Problems
Pregnancy Dangers
Permanent Brain Damage
Sudden Unexplained Death in
Epilepsy (SUDE

HCVD (Hypertensive Cardiovascular Disease)

Definition:

Hypertensive Cardiovascular Disease is a medical term for enlargement of the

heart, heart failure and coronary artery disease that results from high blood pressure.

Etiology:
High blood pressure is the major contributor to hypertensive cardiovascular
disease. When blood pressure increases, it places pressure on blood vessels. This causes
the heart to have to pump harder, which overtime affects the heart muscle causing it to
enlarge.

High blood pressure can also cause stroke and heart disease due to the increased
amount of oxygen that is needed by the heart. It also contributes to blood vessel walls
thickening, which can worsen atherosclerosis, increasing the risks of stroke and heart
attacks.

Clinical Manifestations:

Fatigue.
Irregular pulse or palpitations.
Swelling of feet and ankles.
Weight gain.
Nausea.
Shortness of breath

Management (Surgical, Medical, Pharmacologic, Nursing):

Medications that are used in preventing the blood from clotting, improving the flow of

blood, and lowering your cholesterol

Water pills that help to lower blood pressure

Nitrates to treat chest pain

Statins for treating high cholesterol

Pain in the neck, back, arms, or

shoulders.
Difficulty sleeping flat in bed

(orthopnea)
Bloating and abdominal pain
Foot and ankle swelling
Hypertension

Beta-blockers for lowering blood pressure and reducing the amount of oxygen used by
the heart

Aspirin to prevent blood clots

Cardioverter-defibrillators (ICDs) are implantable devices that can be used to treat

serious, life-threatening cardiac arrhythmias.

A heart transplant or other heart-assisting devices may be necessary.
A pacemaker may be used.
Lifestyle changes like eating a healthy diet and monitoring stress levels are possibly the
best ways to treat and prevent heart problems.

Complications:

Angina
Heart attack
Stroke
Heart failure

Arrhythmias
Sudden death
Ischemic heart disease
Cardiac arrest

Arthiritis

Definition:

Arthritis is inflammation of one or more of the joints. The main symptoms

of arthritis are joint pain and stiffness, which typically worsen with age. The most
common types of arthritis are osteoarthritis and rheumatoid arthritis.

Family History
Age Old
Sex Male
Previous joint injury
Obesity

Etiology:

Clinical Manifestations:

Pain
Stiffness
Swelling
Redness
Decreased range of motion

Management (Surgical, Medical, Pharmacologic, Nursing):

Analgesics. These types of medications help reduce pain, but have no effect on

inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs reduce both pain and

inflammation.
Counterirritants. Some varieties of creams and ointments contain menthol or capsaicin,

the ingredient that makes hot peppers spicy

Disease-modifying antirheumatic drugs (DMARDs). Often used to treat rheumatoid

arthritis, DMARDs slow or stop your immune system from attacking your joints
Biologics. Typically used in conjunction with DMARDs, biologic response modifiers are
genetically engineered drugs that target various protein molecules that are involved in the
immune response.

Corticosteroids. This class of drug, which includes prednisone and cortisone, reduces

inflammation and suppresses the immune system

Joint replacement. This procedure removes your damaged joint and replaces it with an

artificial one. Joints most commonly replaced are hips and knees.
Joint fusion. This procedure is more often used for smaller joints, such as those in the
wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks
those ends together until they heal into one rigid unit

Complications:

Twisted joints
Deformed joints

 Pneumonia

Definition:

Penumonia is a lung infection. A person with pneumonia may cough, have

fever, and have hard time breathing.

Types of pneumonia include:

a. Community-associated pneumonia acquired from the community,

school or workplace.

b. Healthcare-acquired pneumonia acquired from the hospital or in the

clinical setting

Etiology:

Bacteria
Viruses
Long-term or chronic disease like asthma, heart disease, cancer, or diabetes

Clinical Manifestations:

Cough

Fever.

Fast breathing and feeling short of breath.

Shaking and "teeth-chattering" chills.

Chest pain that often feels worse when you cough or breathe in.

Fast heartbeat.

Feeling very tired or very weak.

Nausea and vomiting

Diarrhea

Antibiotics
Bronchodilators
Nebulisation
Metered-dose inhalers
Oxygen therapy
Fluid resuscitation
Corticosteroids
Dotrecogin Alfa

Management (Surgical, Medical, Pharmacologic, Nursing):

Complications:

Meningitis
Pleural Effusion
Sepsis
Hypoxia
Hypoxemia
Bacteremia
Lung abscess
Difficulty breathing

 Urinary Tract Infection

Definition:
A urinary tract infection (UTI) is an infection in any part of your urinary system

your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract
the bladder and the urethra

Urinary tract infections (UTIs) are very common particularly in women, babies

and the elderly. Around one in two women and one in 20 men will get a UTI in their lifetime.

Etiology:

The most common UTIs occur mainly in women and affect the bladder
and urethra.

Infection of the bladder (cystitis). This type of UTI is usually caused by Escherichia coli
(E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract. Sexual
intercourse may lead to cystitis, but you don't have to be sexually active to develop it. All
women are at risk of cystitis because of their anatomy specifically, the short distance

from the urethra to the anus and the urethral opening to the bladder.

Infection of the urethra (urethritis). This type of UTI can occur when GI bacteria spread
from the anus to the urethra. Also, because the female urethra is close to the vagina,
sexually transmitted infections, such as herpes, gonorrhea and chlamydia, can cause
urethritis.

Other causes:

Irritation from having sex

Use of condoms
Enlarged prostate gland
Bacteria from the bowel that live on the skin near the rectum or in the vagina
Waiting too long to urinate

Other risk factors:

Diabetes Melllitus
Pregnancy
Menopause
UTIs as a child
Gender

Obesity
Age
Kidney problems
Chronic illnesses
Long-term catheter use

Clinical Manifestations:

Pain or burning when you urinate.

You feel like you have to urinate often, but not much urine comes out when you do.
Your belly feels tender or heavy.
Your urine is cloudy or smells bad.
You have pain on one side of your back under your ribs. This is where your kidneys are.
You have fever and chills.
You have nausea and vomiting.
Cloudy urine
needing to urinate more often during the day or night, or both
urine that smells unusually unpleasant
blood in your urine (haematuria)
pain in your abdomen (tummy)
a feeling of tenderness around your pelvis
back pain
a general sense of feeling unwell
a high temperature (fever) of 38C (100.4F) or above
uncontrollable shivering
Diarrhea

Management (Surgical, Medical, Pharmacologic, Nursing):

Antibiotics
Increase Fluid Intake
Proper Hygine
Antipyretics for fever
NSAIDs or Pain Relievers for pain

Complications:

Systemic Infection
Bacteremia
Ascending infection

 AGE (Acute Gastroenteritis)

Definition:
Acute Gastroenteritis is an extended and possibly fatal attack of stomach flu. It is
an inflammation in the bowels caused mainly by an infection.

Also known as "stomach flu," which is an infection of the stomach and intestines.

Etiology:

Bacterial infection
Infection by parasites like giardia
Accidental poisoning or exposure to toxins

Clinical Manifestations:

Diarrhea
Vomiting
Stomach pain

Management (Surgical, Medical, Pharmacologic, Nursing):

Increase fluid intake. Watch out for dehydration.

Introduce food slowly. When the child can drink liquids, start adding bland food, then try

adding meat and vegetables.

Skip over-the-counter medications.
Do not give Ibuprofen as this can upset the child's stomach even more.
Do not give Acetaminophen. This can cause liver problems.
Do not give Antibiotics, these don't help against viruses.
Do not give anti-diarrhea medicines, these can make the infection last longer. They can
also be dangerous for very young children.

Complications:

Dehydration
Fluid and electrolyte imbalance

 Strangulated Inguinal Hernia

Definition:

An inguinal hernia happens when contents of the abdomen, usually fat or part of
the small intestine bulge through a weak area in the lower abdominal wall. The abdomen
is the area between the chest and the hips. The area of the lower abdominal wall is also
called the inguinal or groin region. Inguinal hernias occur at the inguinal canal in the
groin region.

Two types of inguinal hernias:

Indirect inguinal hernias. A defect in the abdominal wall that is present at birth causes an
indirect inguinal hernia. During the development of the fetus in the womb, the lining of
the abdominal cavity forms and extends into the inguinal canal. In males, the spermatic
cord and testicles descend out from inside the abdomen and through the abdominal lining
to the scrotum through the inguinal canal. Next, the abdominal lining usually closes off
the entrance to the inguinal canal a few weeks before or after birth. In females, the
ovaries do not descend out from inside the abdomen, and the abdominal lining usually
closes a couple of months before birth. It appears in 2 to 3 percent of male children;

however, they are much less common in female children, occurring in less than 1 percent.
Direct inguinal hernias. Direct inguinal hernias usually occur only in male adults as aging
and stress or strain weaken the abdominal muscles around the inguinal canal. Previous
surgery in the lower abdomen can also weaken the abdominal muscles. Females rarely
form this type of inguinal hernia. In females, the broad ligament of the uterus acts as an
additional barrier behind the muscle layer of the lower abdominal wall. The broad
ligament of the uterus is a sheet of tissue that supports the uterus and other reproductive
organs.

Etiology:

heredity
personal history of hernias
being male
premature birth
being overweight or obese
pregnancy
cystic fibrosis
chronic cough
frequent constipation
frequently standing for long periods of time

Clinical Manifestations:

small bulge on one or, rarely, on both sides of the groin

discomfort or pain in the groinespecially when straining, lifting, coughing, or

exercisingthat improves when resting

feelings such as weakness, heaviness, burning, or aching in the groin
swollen or an enlarged scrotum in men or boys
burning sensations
sharp pain
heavy sensation in the groin

Management (Surgical, Medical, Pharmacologic, Nursing):

Open Inguinal Hernia Repair (Herniorrhaphy, Hernioplasty)

For open hernia repair surgery, a single long incision is made in the groin.
If the hernia is bulging out of the abdominal wall (a direct hernia), the bulge is
pushed back into place. If the hernia is going down the inguinal canal (indirect),
the hernia sac is either pushed back or tied off and removed.

Laparoscopic Inguinal Hernia Repair

Laparoscopic hernia repair is similar to other laparoscopic procedures.

General anaesthesia is given, and a small cut (incision) is made in or just below
the navel. The abdomen is inflated with air so that the surgeon can see the
abdominal (belly) organs. A thin, lighted scope called a laparoscope is inserted
through the incision. The instruments to repair the hernia are inserted through
other small incisions in the lower abdomen. Mesh is then placed over the defect to
reinforce the belly wall.

Complications:

Incarceration. An incarcerated hernia happens when part of the fat or small intestine from
inside the abdomen becomes stuck in the groin or scrotum and cannot go back into the
abdomen. A health care provider is unable to massage the hernia back into the abdomen.

Strangulation. When an incarcerated hernia is not treated, the blood supply to the small
intestine may become obstructed, causing strangulation of the small intestine. This lack
of blood supply is an emergency situation and can cause the section of the intestine to die.

 Upper Respiratory Tract Infection

Definition:

An upper respiratory tract infection, or upper respiratory infection, is an infectious

process of any of the components of the upper airway.

Infection of the specific areas of the upper respiratory tract can be named

specifically. Examples of these may include rhinitis (inflammation of the nasal cavity), sinus
infection (sinusitis or rhinosinusitis) - inflammation of the sinuses located around the nose,
common cold (nasopharyngitis) - inflammation of the nares, pharynx, hypopharynx, uvula, and
tonsils, pharyngitis (inflammation of the pharynx, uvula, and tonsils), epiglottitis (inflammation
of the upper portion of the larynx or the epiglottis), laryngitis (inflammation of the larynx),
laryngotracheitis (inflammation of the larynx and the trachea), and tracheitis (inflammation of
the trachea).

Etiology:

Direct invasion of the inner lining (mucosa or mucus membrane) of the upper airway by

the culprit virus or bacteria.

Clinical Manifestations:

Management (Surgical, Medical, Pharmacologic, Nursing):

Rest is an important step in treating upper respiratory infections. Usual activities, such as,

working and light exercising may be continued as much as tolerated.

Increased intake of oral fluids is also generally advised to keep up with the fluid loss

from runny nose, fevers, and poor appetite associated with upper respiratory infections.
Acetaminophen (Tylenol) can be used to reduce fever and body aches.

Nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) can be used for

body aches and fever.

Antihistamines such as diphenhydramine (Benadryl) are helpful in decreasing nasal

secretions and congestions.

Nasal ipratropium (topical) can be used to diminish nasal secretions.
Cough medications (antitussives) can be used to reduce cough. Many cough medications
are commercially available such as dextromethorphan, guaifenesin (Robitussin), and

codeine all have shown benefits in reducing cough in upper respiratory infections.
Steroids such as (dexamethasone (Decadron )and prednisone orally (and nasally) are
sometimes used reduce inflammation of the airway passage and decrease swelling and

congestion.
Honey can be used in reducing cough.
Decongestants such as pseudoephedrine (Sudafed) Actifed oral, phenylephrine (Neosynephrine nasal) can be used to reduce nasal congestion (generally not recommended in
children less than 2 years of age and not recommended for individuals with high blood

pressure).
Antibiotics are sometimes used to treat upper respiratory infections if a bacterial infection
is suspected or diagnose

Complications:

 Hypertension

Definition:
High blood pressure; transitory or sustained elevation of systemic arterial blood
pressure to a level likely to induce cardiovascular damage or other adverse consequences.

Hypertension may be classified as essential or secondary. Essential hypertension

is the term for high blood pressure with unknown cause. It accounts for about 95% of
cases. Secondary hypertension is the term for high blood pressure with a known direct
cause, such as kidney disease, tumors, or birth control pills.

Etiology:

The exact causes of high blood pressure are not known, but several factors and
conditions may play a role in its development, including:

Obesity
Smoking
Diabetes
Sedentary lifestyle
High level of salt intake
Insufficient calcium, potassium, and magnesium consumption
Vit D deficiency
Aging
Stress
Alcohol consumption
Use of birth control pills
Genetics
Chronic Kidney Disease
Adrenal and thyroid problems

Clinical Manifestations:

There is no guarantee that a person with hypertension will present any symptoms
of the condition. For this reason, it is advisable to undergo periodic blood pressure
screenings even when no symptoms are present.

Other symptoms accompanying high blood pressure:

Severe headache
Fatigue
Confusion
Dizziness
Nausea
Blurred vision
Chest pain
Breathing problems
Irregular heartbeat
Presence of blood in the urine

Management (Surgical, Medical, Pharmacologic, Nursing):

The main goal of treatment for hypertension is to lower blood pressure to less than
140/90 mmHg or even lower in some groups, such as people with Diabetes and Chronic
Kidney Disease.

Diuretics. They help the kidneys eliminate sodium and water from the body.
Anti-adrenergics lower blood pressure by limiting the action of the hormones epinephrine
and norepinephrine, thereby relaxing the blood vessels and reducing the speed and force
of the hearts contractions

Calcium-channel blockers slow the movement of calcium into the smooth-muscle cells of
the heart and blood vessels. This weakens heart muscle contractions and dilates blood
vessels, lowering blood pressure.

Ace Inhibitors. These agents prevent your kidneys from retaining sodium and water by
deactivating angiotensin-converting enzyme, which converts inactive angiotensin I to the
active angiotensin II.

Angiotensin-Receptor Blockers. These agents blocks angiotensin II from constricting the

blood vessels and stimulating salt and water retention.

Complications:

Stroke
Heart attack
Heart failure

 References

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http://www.healthline.com/health/hypertensive-heart-disease

Enrico Forte and Valerie Forte. (2014). What is Hypertensive Cardio Vascular Disease?
Retrieved from http://www.mediterraneanbook.com/2011/02/09/hypertensive-cardiovascular-disease/

Gardner, Amanda. (2015). The Truth About Stomach Flu. Retrieved

http://www.webmd.com/parenting/features/the-truth-about-stomach-flu

Lloyd, William. (2013). Complications of Epilepsy. Retrieved from

http://www.healthgrades.com/conditions/9-complications-of-epilepsy

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Makati Medical Center. (2015). Acute Gastroenteritis. Retrieved from

http://www.makatimed.net.ph/main.php?id=419

Mayo Clinic Staff. (2014). Grand mal Seizure. Retrieved from

http://www.mayoclinic.org/diseases-conditions/grand-malseizure/basics/complications/con-20021356

Mayo Clinic Staff. (2015). Arthritis. Retrieved from http://www.mayoclinic.org/diseasesconditions/arthritis/basics/treatment/con-20034095

Mayo Clinic Staff. (2015). Pneumonia. Retrieved from

http://www.mayoclinic.org/diseases-conditions/pneumonia/basics/complications/con20020032

Mayo Clinic Staff. (2015). Viral gastroenteritis (stomach flu). Retrieved from
http://www.mayoclinic.org/diseases-conditions/viralgastroenteritis/basics/complications/con-20019350

Nursingcrib.com. (2015). Seizure Disorder. Retrieved from

http://nursingcrib.com/nursing-notes-reviewer/seizure-disorder/

Webmd.com (2015). Pneumonia. Retrieved from

http://www.webmd.com/lung/tc/pneumonia-treatment-overview