Page 1 of 31

I. General Profile
Name: Mr. X
Age: 24 y/o
Date of Birth: May 26, 1989
Gender: Mae
Marita !tat"#: !inge
$thni% Ba%&gro"nd: 'an&anaey
Addre##: (am) 4, *"+a, Beng"et
,eigion: ,oman (athoi%
Admitting Diagno#i#: $)ie)#y, Gt% !ei-"re
.ina//rin%i)a Diagno#i#: $)ie)#y, Gt% !ei-"re
Admitting /hy#i%ian: Dr. Mar& Donn D. Andre#, M.D
Date and *ime Admitted: 0an"ary 19, 21142 8:11 /.M
Date 3anded: 0an"ary 21 to 0an"ary 22,2114 at 4 to 5 )m #hift
II. Chief Complaint/
Mr. X %om)ain# of intermittent #ei-"re.
III. History of Present Illness
*he )re#ent %ondition #tarted 2 ho"r# /*( 6hen Mr. X 6a# noted to ha7e
generai-ed +ody #ha&ing 6ith ")6ard roing of eye+a# hen%e )rom)ted %on#"t hen%e
admi##ion )atient 6a# diagno#ed 6ith e)ie)#y 8 year# ago.
IV. Past Medical History
A%%ording to Mr. X 6hen he 6a# 8 year# od he 6a# ho#)itai-ed at BG3M( d"e
to meningiti#. Mr. X a#o e9)erien%e# e)i#ode of #ei-"re 6hen he 6a# 21 year# od, no
%on#"tation 6a# done. Mr. X %aimed that intermittent #ei-"re ha))ened for 2:5 month#
onger and no maintenan%e 6a# ta&en. May 2115 he 6a# admitted for d"e to ty)hoid fe7er.
V. Social and Environmental History
Mr. X i# a high #%hoo grad"ate. A%%ording to him he 6or&# a# a farmer together 6ith
hi# father on their o6n farm. Mr. X i7e# in their o6n ho"#e together 6ith hi# famiy, 6hi%h i#
a one #tory ho"#e made of #emi:)ermanent materia# and %ement. *hey "#e to ride a
;eee)ney going to the ho#)ita. *hey "#ed mo"ntain 6ater r"n# from a ong ho#e for
drin&ing and %oo&ing )"r)o#e. Mr. X #tated they eat 5 time# a day. *heir food i# mainy
meat and 7egeta+e#. A%%ording to him he #mo&e and drin& a%ohoi% +e7erage#
o%%a#ionay.
VI. Family History
A%%ording to Mr. X they ha7e famiy hi#tory of hy)erten#ion +"t no famiy hi#tory
of $)ie)#y. No famiy hi#tory of (an%er, DM and *B.

VII. Physical Examination
a. ! "reas of "ssessment
I. Psycholo#ical Stat$s
A%%ording to $ri& $ri&#on the %ri#i# fa%ed +y yo"ng ad"thood <age 18 to
Page 2 of 31
41= i# termed >ntima%y 7#. >#oation. D"ring thi# time, ad"t# +egin to #hare their #e7e#
more intimatey 6ith other#. ?e e9)ore reation#hi)# eading to6ard onger term
%ommitment# 6ith #omeone other than a famiy mem+er. !"%%e##f" %om)etion of thi#
#tage %an ead to %omforta+e reation#hi)# and a #en#e of %ommitment, #afety, and %are
6ithin a reation#hi). A7oiding intima%y, fearing %ommitment and reation#hi)# %an ead to
i#oation, oneine##, and #ometime# de)re##ion. !"%%e## in thi# #tage 6i ead to the
7irt"e of o7e.
Mr. X had fini#hed high #%hoo ed"%ation and )re#enty 6or&ing
a# a farmer to earn for a i7ing. *he +eha7ior i# e@"a to hi# de7eo)ment ta#&.
!o"r%e: Genera /#y%hoogy 6ith Dr"g $d"%ation for N"r#ing
II. Mental and Emotional Stat$s
,e#)on#i7e and i# oriented to time, date, )a%e and )er#on. 3e %an
identify name# and thing# +eing a#&ed. 3e %an #)ea& >o%ano, *agaog, and 'an&anaey .
3e 6a# %on#%io"#, and %ogni-ant of 6hatA# ha))ening aro"nd him. *he )atient i# 6ide
a6a&e and attenti7e and ha# inta%t hearing %a)a+iity. 3e demon#trate# good reation#hi)
6ith the )eo)e aro"nd him. D"ring the inter7ie6, the %ient a))ear# to +e rea9ed and i#
%oo)erati7e.
III. Environmental Stat$s
Mr. X 6a# admitted at Bag"io Genera 3o#)ita and medi%a (enter at
Medi%a ?ard. *he 6ard %ontain# a))ro9imatey 11 +ed# for )atient#2 ha# ade@"ate
#)a%e, eno"gh for a the )atient# %on#idering that they a#o ha7e their 6at%her# and
#t"dent n"r#e# to ta&e %are of the %ient#. 3i# +ed i# o%ated near the 6indo6 6hi%h
)ro7ide# ade@"ate 7entiation for re#t and %omfort.

IV. Sensory Stat$s
*he )atient ha# no diffi%"ty in o)ening and %o#ing hi# eye#, )")i# are
rea%ti7e to ight and a%%ommodation. 3e %an di#ting"i#h o+;e%t# and a+e to di#%riminate
odor# #"%h a# fo" #meing odor. ,e#)ond @"i%&y 6hen her name 6a# %aed from a far
and %o#e di#tan%e in a o"d and #oft 7oi%e. 3e 6a# a+e to re#)ond to heat, %od and )ain
a))ro)riatey to a %ertain #tim"i. 3i# i)# are +ro6n in %oor, hi# tong"e i# )in&2 %an ta#te
any food #er7ed a# a))ro)riate.
V. Motor Stat$s
Mr. X ha# ")right and #teady gait 6ith o))o#ing arm #6ing2 6a&#
"naided and a+e to maintain hi# +aan%e. Mr. X %an )erform a%ti7itie# of daiy i7ing
6itho"t a##i#tan%e.
VI. %$tritional Stat$s
/rior to admi##ion )atient %aimed that he ha# a good a))etite2 3e "#"ay
eat# 5:4 mea# a day and drin&# 4:8 ga##e# of 6ater. D"ring hi# ho#)itai-ation, heA# diet 6a#
on DA*2 6ith >B. of /N!! >C X 16 ho"r# at 18:16gtt#/min2 3e 6a# ad7i#ed to in%rea#ed f"id
inta&e.
VII. Fl$ids and Electrolytes Stat$s
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/atient %on#"med f"id inta&e amo"nting to 811:1111 m of 6ater and 6ith
>ntra7eno"# ."id of /N!!1C 9 16 ho"r# at 511%% e7e 6a# reg"ated 18:16gtt#/min2 ?ith #&in
t"rgor of 2:5 #e%ond#.
VIII. Elimination Stat$s
/atient "rinate# 6:8 time# a))ro9imatey 1211 m a day 6ith no %om)ain of
)ain d"ring "rination, and defe%ated on%e )er day.
I&. Circ$latory Stat$s
Mr. X ha# a )"#e rate ranging from 61:91 +eat# for 1 f" min"te, 6ith a
#trong @"aity, reg"ar in rhythm ta&en at the radia )"#e. Ci)# and %on;"n%ti7a are not )ae
in%"ding the #&in and nai +ed#, 6ith a %a)iary refi of 2:5 #e%ond#. *here 6a# no heart
m"rm"r# heard ")on a"#%"tation. Bood )re##"re range# from 111/41 mm3g to 111/81 mm3g
ta&en on the +ra%hia artery.
&. 'espiratory Stat$s
*he re#)iratory rate of the )atient range# from 16 to 21 +reath# for one f"
min"te. ,hythm and re#)iration )attern are reg"ar. No ad7entitio"# #o"nd heard ")on
a"#%"tation of +oth "ng fied#. No#e a))ear# norma 6ith )atent nare# +iateray.
&I. (emperat$re Stat$s
/atient remained afe+rie d"ring the 5 day#. Body tem)erat"re range# from
56.8 to 54.4 degree# (e#i"# ta&en at the a9iary )art e7ery fo"r ho"r.
&II. Inte#$mentary Stat$s
/atient ha# fair +ro6n #&in %om)e9ion. ?ith #&in t"rgor of 2:5 #e%ond#,
ro"gh and normay 6arm to to"%h. 3air i# e7eny di#tri+"ted. Nai# are ro"gh, firm, trimmed
and nai +ed# are )in&.
&III. 'est and Comfort Stat$s
Mr. X re)orted that he i# ea#iy a6a&ened 6hen #ee) 6a# interr")ted 6ith
medi%a and n"r#ing inter7ention#. 3e 6a# a+e to na) at noon and 8:6 ho"r# at night. Maintain
#emi fo6er# )o#ition. 3e #tated that he i# %omforta+e eno"gh2 that he i# #o "%&y to ha7e a
7ery o7ing and #"))orti7e famiy, 6ho a6ay# 6at%h him and ta&e %are of him.
). Head to (oe "ssessment
. Head Go+"ar in #ha)e <normo%e)hai%=. 3air i#
+a%& in %oor and e7eny di#tri+"ted, 6ith
minima fa&e# and oiine## noted. No
tenderne## or e#ion# ")on in#)e%tion.
*. Eyes !ymmetri%a and in ine 6ith ea%h other.
/in&i#h )a)e+ra %on;"n%ti7a, )")i# are
e@"ay ro"nd, rea%ti7e to ight and
a%%ommodation, a+e to foo6 )enight 6ith
ga-e, m"%o"# mem+rane are moi#t and
ight )in&. A+e to di#ting"i#h %oor# and
%an read o"r name)ate ")on
Page 4 of 31
demon#tration.
!. Ears Are e@"a in #i-e +iateray, no e#ion noted
")on in#)e%tion. $ar %ana# a))ear )in&
6ith minima %er"men +"id:"), 6ith inta%t
tym)ani% mem+rane. !&in i# #ame in %oor
a# in the %om)e9ion. A+e to hear and
re)eat the 6ord# that 6ere "#ed d"ring
6hi#)er te#t.
+. %ose and Sin$ses No#e i# )atent, #e)t"m i# o%ated in the
midine, no di#%harge# and no na#a faring
noted. Na#a m"%o#a i# dar& )in&, moi#t
and free of e9"date#. Na#a #e)t"m i#
inta%t. No %om)ain# of tenderne## ")on
)a)ation of #in"#e#
,. Mo$th *he mo"th i# #ymmetri%a in a))earan%e
and mo7ement, 6ith a 7i#i+e margin. *he
i)# are )in&i#h in %oor, #mooth and moi#t
6itho"t e#ion# or #6eing. *eeth are 6hite
to yeo6i#h in %oor. *he tong"e i# )in&
and he %an ta#te any food #er7ed a#
a))ro)riate.
-. %ec. and clavicles *he ne%& i# #ymmetri%a 6ith the head.
A+e to %hange dire%tion of the head
6itho"t %om)ain# of )ain. (arotid )"#e i#
+iateray #ymmetri%a, f" and #trong
)"#e#, ;"g"ar 7ein i# not di#tended2
#")erfi%ia %er7i%a ym)h node# are
)a)a+e +"t are non:tender.
/. Chest A))ear# #ymmetri%a 6ith ri+# #o))ing
do6n6ard. !%a)"a i# #ymmetri%a and
non:)rotr"ding. 3i# %he#t e9)an#ion i#
#ymmetri%a 6ith no %om)ain# of DDB. No
ad7entitio"# #o"nd heard ")on a"#%"tation
of +oth "ng fied#. ,e#)iratory rate i# 16:
21 %)m.
0. Cardiac A)i%a )"#e 6ith norma rate and reg"ar
rhythm +et6een 61:91 +)m. No m"rm"r#
heard ")on a"#%"tation.
1. 2reast Areoa# a))eared dar& +ro6n in %oor.
Ni))e# are e@"a in #i-e and non:tender.
3. ")domen .at, #oft, non:tender and ha# a ighter
%oor. !ymmetri%a a+domina mo7ement
%a"#ed +y re#)iration#. No )ain and
tenderne## noted ")on )a)ation.
. Genitals 3e "rinate# 6:8 time# a day 6ith an
e#timated o"t)"t of 1211 %% )er day.
Page 5 of 31
*. M$sc$los.eletal Both e9tremitie# are e@"a in #i-e, 6ith the
#ame %onto"r 6ith )rominen%e# of ;oint#.
No in7o"ntary mo7ement# noted. ,ange of
motion %an +e )erformed normay and
6itho"t diffi%"ty or )ain.
!. Inte#$mentary Generay fair +ro6n #&in %om)e9ion in
%oor. ,o"gh and normay 6arm to to"%h.
3air i# e7eny di#tri+"ted and )re#ent# of
dandr"ff noted . Nai# are ong and dirty
and nai +ed# are )in& 6ith %a)iary refi of
2:5 #e%ond#. A##e##ment for #&in t"rgor
re7eaed 5 #e%ond# to ret"rn to the
)re7io"# #tate 6hen )in%hed.
Page 6 of 31
VIII. 4ia#nostics
Diagno#ti% /ro%ed"re: Complete 2lood Co$nt
Date the diagno#ti% )ro%ed"re 6a# %ond"%ted: 0an"ary 19, 2114
(est %ormal Val$es 'es$lts Implication
3emogo+in Mae: <41:181 g/C= 155 g/C Norma
3emato%rit Mae: 1.41:1.84 Bo E 1.44 E Norma
Ce"&o%yte<?B(= 8:11 9 11F 9/C 16.96 A+o7e norma
range
G#ign of
infammatory
re#)on#e
o%%"r# after
%on7"#ion#
#"%h a#
e)ie)#y.
Differentia (o"nt:
Ne"tro)hi# 1.81:1.41 1.81 A+o7e norma
range
G3igh e7e of
#tre## i# )a%ed
on the +ody:
fa%tor# #"%h a#
#ei-"re#
Cym)ho%yte# 1.21:1.41 1.51 Norma
%reatinine M:61.88:114.92"mo/C 92.59"mo/C Norma
Magne#i"m 1.686:1.166mmo/C 1.16 Norma
/ateet (o"nt 181:441 9 11F9/C 581 Norma
mono%yte 1:1.14 1.14 Norma
#odi"m 158:148mmo/C 148 mmo/C Norma
)ota##i"m 5.8:8.8mmo/C 4.24mmo/C Norma
Source: Medical-Surgical nursing 9
th
Edition Brunner and Suddarth
Diagno#ti% /ro%ed"re: 5'I%"67SIS
Date the diagno#ti% )ro%ed"re 6a# %ond"%ted: 0an"ary 19,2114
(ES( %8'M"6 V"65E 'ES56( IMP6IC"(I8%
"ppearance Cight yeo6 *"r+id
Color #tra6 or am+er #tra6 norma
'eaction 4.6:8 4.8 A%idi%
"l)$min Negati7e Negati7e
Specific Gravity 1.118:1.128 1.118 indi%ate# hydration
#tat"#
S$#ar negati7e Negati7e
Casts none :
P$s cells 1:4 1:2/h)f norma
'2Cs H2 none none
Epithelial Cells rare
Source: Medical-Surgical nursing 9
th
Edition Brunner and Suddarth
Page 7 of 31
I&. Medical 4ia#nosis
$)ie)#y d"e to G*( #ei-"reI
&. Pathophysioplo#y
Grand ma #ei-"re#
!tiffening of the +ody
,e)eated ;er&# of the arm# and
eg#
Co## of %on%io"#ne##
A+norma ne"rona
a%ti7ity on +oth
#ide# of the +rain
Predisposing
Factors
Gender: Male
History of
meningitis
Seizures
History of
typoid fever
$)ie)#y Generai-ed *oni%:(oni%
!ei-"re#
Ater the
ee%tri%a #igna#
in the +rain
Ineffective
individ$al
copin# related
to stress
imposed )y
epilepsy
Poor self
care deficit
related to
decrease
motivation
Fear related
to ever
present
possi)ility
of havin#
sei9$re
'is. for in:$ry
related to loss
of lar#e
m$scle
coordination.
'is. for
depression
related to self
isolation
Page 8 of 31
&I. (reatment and Mana#ement
a. IV F65I4S
%ame Classification Components 5se "dverse
reactions
Si#nificance %$rsin#
Interventions
P%SS 6 >#otoni%
>ntra7eno"#
!o"tion
J$e%troyte#
:1111 m
J!odi"m
:151mmo
J/ota##i"m
:4mmo
J(a%i"m
:1.4mmo
J(horide
:119 mmo
JCa%tate
:28mmo
JD#moaity
:416 mD#m
K#ed +e%a"#e
it ha# no effe%t
on the ti##"e#
and ma&e the
)er#on fee
hydrated
)re7enting
hy)o7oemi%
#ho%&/hy)otent
ion.
:3y)oten#ion
:fe+rie
re#)on#e,
:infe%tion at
the #ite of
in;e%tion.
:7eno"#
throm+o#i#/)h
e+iti#
e9tending from
the #ite of
in;e%tion,
:e9tra7a#ation
:and
hy)er7oemia
*he %ient
e9)erien%ed
+eeding 6hi%h
mean# that +ood i#
%ontin"o"#y
fo6ing o"t from
the +ody. D8C,!
6a# inf"#ed in
order to #"+#tit"te
+ood in the +ood
7e##e# to )romote
%ontin"o"#
%ir%"ation.
JMonitor )atient
fre@"enty for
a. !ign# of
infitration/#"ggi#h
fo6
+. !ign# of
)he+iti#/infe%tion
J(he%& and reg"ate
the dro) rate.
). 4'5GS
4r$# %ame Classifica Mechanism Indication Contraindicati "4VE'SE 4osa#e %$rsin#
Page 9 of 31
Generic name
;2randname<
tion of action ons/
Preca$tions
EFFEC(/
Side effects
Interventions
Dia-e)am
B,AND NAM$:
BAC>KM,
D>A!*A*
For sei9$re
Anti:
an9iety
JA
+en-odia-e)i
nethat
)ro+a+y
)otentiate#
the effe%t# of
GABA,
de)re##e#
the (N! and
#"))re##e#
the #)read of
#ei-"re
a%ti7ity.
JGABA i# a
ne"rotran#mi
tter that
inhi+it#
a%ti7ity in the
+rain.
JManagem
ent of
an9ierty
di#order# of
for #hort
term reief
of the
#ym)tom#
of an9iety
J3y)er#en#iti7
ity
J(ontraindi%at
ed in )atient#
hy)er#en#iti7e
to dr"g or #oy
)rotein2 in
)atient#
e9)erien%ing
#ho%&, %oma,
or a%"te
a%oho
into9i%ation
<)arentera
form=2 in
)regnant
6omen,
e#)e%iay in
fir#t trime#ter2
and in infant#
yo"nger than
age 6 month#
<ora form=.
J(ontraindi%at
ed in )atient#
6ith a%"te
C%S=
>Dro6#ine##
J#"rred
#)ee%h
Jtremor
Jtran#ient
amne#ia
Jfatig"e
Jata9ia
Jha"%inatio
n
Jheada%he
Jin#omnia
J)arado9i%a
an9iety
CV
>(B %oa)#e
+radi%ardia,h
y)oten#ion.
GI=
Jna"#ea,%on
.or )ain:
>B
admini#tra
tion
51 mg @ 6
ho"r not to
e9%eed
121 mg/
day
JA##e## )ain
<note ty)e,
o%ation, and
inten#ity= )rior to
and 1:2 hr
foo6ing
admini#tration.
J(a"tion )atient
to a7oid
%on%"rrent "#e
of a%oho,
a#)irin, N!A>D#,
a%etamino)hen,
or other D*(
medi%ation#
6itho"t
%on#"ting
heath %are
)rofe##iona.
JAd7i#e )atient
to %on#"t if
ra#h, it%hing,
7i#"a
di#t"r+an%e#,
tinnit"#, 6eight
gain, edema,
+a%& #too#,
Page 10 of 31
ange:%o#"re
ga"%oma.
JK#e
%a"tio"#y in
)atient# 6ith
i7er or rena
im)airment,
de)re##ion,
hi#tory of
#"+#tan%e
a+"#e, or
%hroni% o)en:
ange
ga"%oma. K#e
%a"tio"#y in
edery and
de+iitated
)atient#.
#ti)ation,diarr
hea 6ith
re%ta form
G5=
J>n%ontinen%
e, "rine
retention
HEP"(IC=
J;a"ndi%e
'espiratory=
Jre#)iratory
de)re##ion,a
)nea.
8(HE'=
>atered
i+ido
)er#i#tent
heada%he, or
inf"en-a:i&e
#yndrome#
<%hi#, fe7er,
m"#%e# a%he#,
and )ain= o%%"r.
J$ffe%ti7ene##
of thera)y %an
+e
demon#trated
+y de%rea#e in
#e7erity of )ain.
/atient# 6ho do
not re#)ond to
ony N!A>D#
may re#)ond to
another.
Page 11 of 31
4r$# %ame
Generic name
;2randname<
Classifica
tion
(herape$tic
action
Indication Contraindicati
ons/
Preca$tions
"4VE'SE
EFFEC(/
Side effects
4osa#e %$rsin#
Interventions
Phenytoin
4ilatin Antie)ie)t
i%
May
e#ta+ii-e
ne"rona
mem+rane
and imit
#ei-"re
a%ti7ity either
+y in%rea#ing
eff"9 or
de%rea#ing
inf"9 of
#odi"m ion#
a%ro## %e
mem+rane in
the motor
%orte9 d"ring
generation of
ner7e
im)"#e#
J*o %ontro
toni%:
%oni<grand
ma= and
%om)e9
)artia
<tem)ora
o+e
#ei-"re=.
J*o )re7ent
and treat
#ei-"re#.
J!tat"#
e)ie)ti%"#.
.
J%ontraindi%at
ed in )ati8ent#
hy)er#en#iti7e
to dr"g, in
tho#e 6ith
ange:%o#"re
ga"%oma, and
in tho#e 6ho
6ear #oft
%onta%t en#e#
JK#e
%a"tio"#y in
)atient# 6ith
mar&ed
hy)erten#ion,
%ardia%
di#order#,
ad7an%ed
arterio#%eroti%
%hange#, ty)e
1 dia+ete#, or
hy)erthyroidi#
m2 in %hidren
6ith o6 +ody
6eight2 and in
edery
)atient#.
J3eada%he,
di--ine##,
#omnoen%e,
in#omia,
fatig"e,
tiredne##,
tinnit"#,
o)hthami%
effe%t
JDy#)e)#ia,
G> )ain,
,hemo)ty#i#,
)haryngiti#,
+ro%ho#)a#m
#, rhiniti#
JNa"#ea,
7omiting,
%on#ti)ation,
fat"en%e
111mg 1
%a) *>D
J*a&e dr"g 6ith
food2 ta&e ony
the )re#%ri+ed
do#age2 do not
ta&e the dr"g
onger than 1
6ee&
JDi#%ontin"e
dr"g and %on#"t
yo"r heath %are
)ro7ider if ra#h,
diarrhea, or
dige#ti7e
)ro+em# o%%"r
J >n#tr"%t the
%ient to re)ort
#ore throat,
fe7er, ra#h,
it%hing, 6eight
gain, #6eing in
an&e# or
finger#2 %hange#
in 7i#ion2 +a%&
tarry #too#2
#e7ere diarrhea,
right "))er
a+domina )ain,
f"i&e #ym)tom#
Page 12 of 31
Page 13 of 31
&II. %$rsin# 4ia#nosis and Prioriti9ation
A. Ci#t of /ro+em#
"ct$al=
1. .ear reated to e7er )re#ent )o##i+iity of ha7ing #ei-"re
2. >neffe%ti7e indi7id"a %o)ing reated to #tre## im)o#ed +y e)ie)#y
5. /oor #ef %are defi%it reated to de%rea#e moti7ation
Potential
1. ,i#& for in;"ry reated to o## of arge m"#%e %oordination.
2. ,i#& for de)re##ion reated to #ef i#oation
/rioriti-ation
Pro)lem ?$stification
.ear reated to e7er )re#ent
)o##i+iity of ha7ing #ei-"re
Ba#ed on Ma#o6A# 3ierar%hy of need# fear 6a# fir#t
)rioriti-ed +e%a"#e fear %an re#)on#e to )er%ei7ed
threat that i# %on#%io"#y re%ogni-e a# a danger #ign.
>mmediate inter7ention i# needed +e%a"#e it 6i +e a
hindran%e for the )hy#ioogi%a need# to +e met.
>neffe%ti7e indi7id"a
%o)ing reated to #tre## im)o#ed
+y e)ie)#y
>neffe%ti7e indi7id"a %o)ing i# the #e%ond to
)rioriti-e o7er the )ro+em# +e%a"#e thi# %an ead to
ina+iity to form a 7aid a))rai#a of the #tre##or#,
inade@"ate %hoi%e# of )ra%ti%a re#)on#e# and
ina+iity to "#e a7aia+e re#o"r%e#. A))ro)riate
n"r#ing inter7ention i# needed to )re7ent f"rther
%om)i%ation#.
/oor #ef %are defi%it reated to
de%rea#e moti7ation
Ba#ed on Ma#o6A# 3ierar%hy of need# )oor #ef
%are defi%it 6a# the third to )rioriti-e +e%a"#e a%& of
a+iity to )erform hygiene %an ead to de%rea#e #ef:
e#teem.
,i#& for in;"ry reated to o## of
arge m"#%e %oordination.
,i#& for in;"ry 6a# the 4
th
)riority +e%a"#e it i#
reated to #afety of the )atient +"t there are no
)re7enti7e mea#"re# to )re7ent it +"t thro"gh
medi%ation# it %an +e %ontroed.
,i#& for de)re##ion reated to
#ef i#oation
,i#& for de)re##ion reated to #ef i#oation 6a# the
a#t to )rioriti-e +e%a"#e a%& of information or
&no6edge a+o"t the di#ea#e 6hi%h %an ead to
)ro+em# i&e de)re##ion.
Source:
Priority ursing !iagnosis
Eho"#comhttp:$$"""#eho"#com$a%out&'(9))*prioritynursingdiagnosis#html+l,zzlnBm-
Page 14 of 31
&III. %$rsin# Care Plan
"SSESSME%( Explanation of the
pro)lem
82?EC(IVES %5'SI%G
I%(E'VE%(I8%
'"(I8%"6E 8F
%5'SI%G
I%(E'VE%(I8%
EV"65"(I8%
!J
Natata&ot a&o
+a&a
mag&a#ei-"re
"it a&o #a &ahit
an"ng ora#, a#
7er+ai-ed
DJ
Jnarro6ed
fo%"#
Jin%rea#e
aertne##
Jin%rea#e
)er#)iration
N#g. D9:
.ear reated to
e7er )re#ent
)o##i+iity of
ha7ing #ei-"re
,e#)on#e to
)er%ei7ed threat
<rare or imaged= that
i# %on#%io"#y
re%ogni-e a# a
danger.
!*D:
After 2 ho"r# of
effe%ti7e
n"r#ing
inter7ention
%ient 6i %o)e
6ith %ondition
and re%ei7e
ade@"ate
#"))ort.
C*D:
After 24 ho"r#
of effe%ti7e
n"r#ing
inter7ention the
%ient 6i
demon#trate
"nder#tanding
thro"gh "#e of
effe%ti7e %o)ing
+eha7ior# and
re#o"r%e#.
D9:
JMea#"red 7ita
#ign# or
)#y%hoogi%a
re#)on#e to
#it"ation.
J A#%ertained
%ient/!D
)er%e)tion of 6hat
i# o%%"rring and
ho6 thi# affe%t.
JNoted degree of
%on%entration,
fo%"# of attention.
JD+#er7ed and
%om)ared 7er+a
and non 7er+a
re#)on#e.
*9:
JAo6 !D to
remain 6ith %ient
d"ring #ei-"re.
J/re#ented
J A# a +a#eine for
%ient treatment.
J3e) to
dire%t/render
effe%ti7e n"r#ing
%are to6ard#
%ondition
J*hi# may interfere
in %ientA# a+iity to
engage in
ne%e##ary a%ti7itie#.
J*o note
%ongr"en%ie# or
mi#)er%e)tion# of
#it"ation.
J*o de%rea#e fear
of "n&no6n and
ao6 !D/)arent#
#ee mea#"re# ta&en
to )rote%t %hid.
JCimit %onfi%t 6hen
!*D: Goa Met
After 2 ho"r# of
effe%ti7e n"r#ing
inter7ention
%ient 6a# a+e
to %o)e 6ith
%ondition and
re%ei7e
ade@"ate
#"))ort.
C*D: Goa Met
After 24 ho"r#
of effe%ti7e
n"r#ing
inter7ention the
%ient 6a# a+e
to demon#trate
"nder#tanding
thro"gh "#e of
effe%ti7e %o)ing
+eha7ior# and
re#o"r%e#.
Page 15 of 31
o+;e%ti7e
information 6hen
a7aia+e and ao6
%ient to "#e it
freey to a7oid
arg"ing 6ith %ient
)er%e)tion# of the
#it"ation.
J/romoted %ient
%ontro 6here
)o##i+e and he)
identify and a%%e)t
tho#e thing# o7er
6hi%h %ontro i# not
)o##i+e.
JA%&no6edge
"#ef"ne## of fear
for ta&ing %are of
#ef.
$d9:
Jin#tr"%ted )arent#
on )ro)er
)rote%tion,
inter7ention d"ring
%hidA# #ei-"re
a%ti7ity2 )o#itioning,
#afety, air6ay
maintenan%e,
rea##"ran%e
te%hni@"e# and
emergen%y
medi%ine
admini#tration.
J/ro7ided
fear re#)on#e may
im)air rationa
thin&ing.
J*o #trengthen
interna o%"# of
%ontro.
J*o )re7ent #ef
%are defi%it.
J*o )romote
)arent# )arti%i)ation
and to fa#ter #en#e
of %ontro o7er
#it"ation.
J*o )romote
Page 16 of 31
information
regarding
nat"re/ty)e of
#ei-"re, thera)e"ti%
intera%tion# and
ife#tye
modifi%ation.
J$n%o"raged
famiy in7o7ement
in daiy %are of
%hid 6ith goa of
normai-ation and
)romotion of
o)tim"m gro6th L
de7eo)ment.
J>n7o7ed )arent#
in di#%"##ing of
fear#, an9iety and
re#o"r%e and
#"))ort o)tion#
a7aia+e to famiy.
&no6edge of
%ondition, )arenta
inter7ention and
#en#e of %ontro.
J*o )ro7ide ho)e
and )romote famiy
f"n%tioning and
%o)ing.
J*o )romote famiy
integrity and
f"n%tioning.
"ssessment Explanation of the
pro)lem
8):ective %5'SI%G
I%(E'VE%(I8%
'ationale Eval$ation
!J
M3indi &o aam
ang gaga6in
&"ng
mag&a&a#ei-"re
)a a&oN, a#
7er+ai-ed
DJ@"iet
J%am
J%onf"#e
>na+iity to form a
7aid a))rai#a of
the #tre##or#,
inade@"ate %hoi%e#
of )ra%ti%ed
re#)on#e#, and/or
ina+iity to "#e
a7aia+e re#o"r%e#
!*D:
After 8 ho"r#
of rendering
effe%ti7e
n"r#ing %are
%ient 6i
7er+ai-e
a6arene## of
o6n %o)ing
a+iitie#.
D9:
Jdetermine
indi7id"a #tre##or#.
Ja##e##ed e7e of
an9iety and %o)ing
on an ongoing
+a#i#.
*X:
Jnote the )o##i+iity
of heath )ro+em
o%%"rring to on%e
indi7id"a.
Jhe)# red"%e
an9iety.
!*D:
Goa met. After 8
ho"r# of n"r#ing
%are. (ient
7er+ai-ed
a6arene## of o6n
%o)ing a+iitie#.
C*D:
Goa met. After
Page 17 of 31
/oor
%on%entration
Diagno#i#:
>neffe%ti7e
indi7id"a %o)ing
reated to
#tre##e# im)o#ed
+y $)ie)#y
C*D:
After 48:42
ho"r# of
rendering
effe%ti7e
n"r#ing %are
%ient 6i meet
)#y%hoogi%a
need# a#
e7iden%ed +y
a))ro)riate
e9)re##ion of
feeing#, and
"#e of
re#o"r%e#
J)ro7ide for a @"iet
en7ironment
J)ro7ide for
grad"a
im)ementation and
%ontin"ation of
ne%e##ary
+eha7ior/ife#tye
%hange#.
$DX:
Jen%o"raged
7er+ai-ation of
fear# and an9ietie#
and e9)re##ion# of
feeing#.
Je9)ain di#ea#e
)ro%e##,
)ro%ed"re#, and
e7ent# in a #im)e
%on%i#e manner.
Jan9iety i#
in%rea#ed +y noi#y
#"rro"nding#.
Jenhan%e#
%ommitment to )an.
Jhe)# red"%e
an9iety/fear, ao6#
%ient to dea 6ith
reaity.
Jmay he) %ient to
e9)re## emotion#,
gra#) #it"ation, and
fee more in %ontro.
48:42 ho"r# of
n"r#ing %are.
>nter7ention %ient
meet
)#y%hoogi%a
need# a#
e7iden%ed +y
a))ro)riate
e9)re##ion# of
feeing#, and "#e
of re#o"r%e#.
Page 18 of 31
"ssessment Explanation of
the pro)lem
8):ective Plannin# 'ationale Eval$ation
!JAAmadi na
&ayat nga
agdigo# &en
ag#"&at ti +ad"
na #anto ang
ag#"&at n" ada iti
n"r#e nga
mangi+aga AAa#
7er+ai-ed +y the
mother.
DJ/oor
grooming.
>m)aired a+iity
to )erform or
%om)ete
feeding,
+athing/hygiene
dre##ing and
grooming
a%ti7itie# for
one#ef.
!*DJAfter 8
ho"r# of
rendering
effe%ti7e n"r#ing
%are, %ient 6i +e
moti7ated to
)erform #ef %are
a%ti7itie# 6ithin
e7e of o6n
a+iity.
C*DJAfter 24 hr#
of rendering
D9:
Jdetermine age and
de7eo)menta i##"e#.
Jnote other ethoogi%a
fa%tor# )re#ent in%"ding
en7ironmenta fa%tor#.
*9:
J$#ta+i#h remoti7ation
and a##i#t reha+iitation
)rogram.
Ja##i#t 6ith ne%e##ary
ada)tation# to
Jaffe%ting a+iity of
indi7id"a to
)arti%i)ate in o6n
%are.
Jto di#%o7er +arrier#
to )arti%i)ation in
regimen.
Jto enhan%e %ient
%a)a+iitie# and
!*D: Goa met.
After 8 hr# of
rendering n"r#ing
%are. (ient
in%rea#ed
moti7ation to
)erform #ef %are
a%ti7itie# 6ithin
e7e of o6n a+iity.
C*D: Goa met.
After 24 hr# of
rendering n"r#ing
Page 19 of 31
J+ody odor
noted.
Jdry +ody
Jdandr"ff noted
Jong nai# 6ith
dirt noted.
J)oor ora
hygiene.
N#g. D9:
/oor #ef %are
defi%it reated to
de%rea#e
moti7ation.
effe%ti7e n"r#ing
%are %ient 6i
demon#trate #ef
%are need# and
ife#tye %hange#.
a%%om)i#h ADC#.
J)ro7ide for
%omm"ni%ation among
tho#e 6ho are in7o7ed
in %aring for a##i#ting
the %ient.
J)romote %ient/!D
)arti%i)ation in )atient
identifi%ation and
de#ired goa# and
de%i#ion ma&ing.
$d9:
J$n%o"raged #ef %are
)ra%ti%e# and goa# that
)romote heath
Jdi#%"## the im)ortan%e
of hygiene.
)romote
inde)enden%e.
Jto en%o"rage %ient
to +"id on
#"%%e##e#.
Jenhan%e#
%oordination and
%ontin"ity of %are.
Jenhan%e#
%ommitment to )an
o)timi-ing o"t%ome#
and #"))orti7e
re%o7ery and heath
%are #it"ation.
Jto fo#ter #ef %are
and #ef
determination.
Jto )re7ent the
#)read of
mi%roorgani#m#
%a"#ing infe%tion.
%are %ient
demon#trated #ef
%are need# and
ife#tye %hange#.
Page 20 of 31
"SSESSME%( P"(H8PH7SI868G
7
82?EC(IVES %5'SI%G
I%(E'VE%(I8%
'"(I8%"6E 8F
%5'SI%G
I%(E'VE%(I8%
EV"65"(I8%
!J
M*"mitiri& mata at
nanginginig ang
&ata6an nya a#
7er+ai-ed +y
)atientN
DJ
M"#%e
%ontra%tion
!hi7ering
?ea&ne##
>rrita+iity
N#g. D9:
,i#& for in;"ry
reated to o## of
!ei-"re# are
di#t"r+an%e# in
norma +rain f"n%tion
re#"ting from
a+norma ee%tri%a
di#%harge in the
+rain, 6hi%h %an
%a"#e o## of
%on#%io"#ne##,
"n%ontroed +ody
mo7ement#, %hange#
in +eha7ior# and
#en#ation and
%hange# in a"tonomi%
#y#tem.
>t i# a#o a# a re#"t of
en7ironmenta
%ondition# intera%ting
6ith indi7id"a#
!*DJ After 8
ho"r# of
effe%ti7e
n"r#ing
inter7ention#
the )atient
6a# a+e to
demon#trate
ife#tye
%hange# to
red"%e ri#& of
in;"ry %a"#ing
tra"ma.
C*DJAfter 48
ho"r# of
n"r#ing
inter7ention
D92
JMonitored 7ita #ign#
and re%orded.
JA##e##ed mood,
%o)ing a+iitie#,
)er#onaity #tye.
JA#%ertain &no6edge of
#afety need#/in;"ry
)re7ention and
moti7ation to )re7ent
in;"ry in home,
%omm"nity and 6or&
#etting.
JDetermined )otentia
JA# a +a#eine
data for %ient
treatment.
J*hat may re#"t
in in%rea#ed ri#&:
ta&ing 6itho"t
%on#ideration of
%on#e@"en%e#.
J*o determine
the e9tent of
%ientA#
&no6edge on
de#%ri+ing
%ondition.
J*hat may trigger
%ientA# %ondition.
!*D:Goa met
After 8 ho"r# of
n"r#ing
inter7ention the )t.
6a# a+e to
demon#trate
a))ro)riate
+eha7iora and
ife#tye %hange# to
he) #ef from
in;"ry %a"#ing
tra"ma.
C*D:Goa met
After 48 ho"r# of
n"r#ing
inter7ention the
Page 21 of 31
arge m"#%e
%oordination.
ada)ti7e and
defen#i7e.
!o"r%e:
."ndamenta
of N"r#ing )g.
414
the )atient
6a# a+e to
demon#trate
a=ife#tye
%hange#
+= >dentify
re#o"r%e# to
a##i#t in
)romoting a
#afe
en7ironment.
%= >dentify and
%orre%t
)otentia ri#&
fa%tor# in the
en7ironment to
he) #ef from
in;"ry %a"#ing
tra"ma.
for a+"#i7e +eha7ior +y
famiy
mem+er#/!D<#=/)eer#.
*X
J'e)t #ide rai# ") 6ith
+ed in the o6e#t
)o#ition.
JMaintained #tri%t +ed
re#t if )rodroma #ign#
or a"ra e9)erien%e.
JCoo#ened %on#tri%ti7e
%othing.
J*"rned head to #ide.
J%rade head, )a%ed on
#oft area or a##i#t to
foor if o"t of +ed.
JMinimi-e# in;"ry
#ho"d #ei-"re
o%%"r 6hie
)atient i# in +ed.
J/atient may fee
re#te## to
am+"ate or e7en
defe%ate d"ring
a"ra )ha#e that
inad7ertenty
remo7ing #ef
from #afe
en7ironment and
ea#y o+#er7ation.
J.or %ientA#
%omfort.
J3e) maintain
air6ay and
red"%e ri#& of
ora tra"ma.
JGente g"iding
of e9tremitie#
red"%e# ri#& of
)hy#i%a in;"ry
6hen )atient
a%&# 7o"ntary
m"#%e %ontro.
J!)e%ifi% dr"g
thera)y de)end#
on #ei-"re ty)e
6ith #ome
)atient 6a# a+e to
demon#trate
a=ife#tye %hange#
+= >dentify
re#o"r%e# to a##i#t
in )romoting a #afe
en7ironment.
%= >dentify and
%orre%t )otentia
ri#& fa%tor# in the
en7ironment to
he) #ef from
in;"ry %a"#ing
tra"ma.
Page 22 of 31
JAdmini#tered
medi%ation# a#
indi%ated.
$D9
JDi#%"##ed #ei-"re
6arning #ign# and "#"a
#ei-"re )attern.
J,eoriented )atient
foo6ing #ei-"re a%ti7ity.
J$d"%ated famiy to
initiate #ei-"re
)re%a"tion at home.
J*a"ght famiy on
#ei-"re fir#t aid#:
>f at ri#& of faing
at +eginning of
e)i#ode, ea#e to
foor
*"rn to #ide:ying
)atient# re@"iring
)oythera)y or
fre@"ent
medi%ation
ad;"#tment.
J$na+e# the
)atient to )rote%t
#ef from in;"ry.
J/atient may +e
%onf"#ed,
di#oriented after
#ei-"re and need
he) to regain
%ontro and
ae7iate an9iety.
J*o )re7ent
)hy#i%a harm.
J*o )re)are the
famiy for
emergen%ie#.
Page 23 of 31
)o#ition
/re7ent from
hitting head on
o+;e%t#
Do not attem)t to
re#train/"#e
for%e
(a $M! if
#ei-"re )er#i#t
more than 8min#
for re)eated
#ei-"re#
Ao6 #ei-"re to
end
#)ontaneo"#y.
Page 24 of 31
"ssessment Explanation of the
pro)lem
8):ective Plannin# 'ationale Eval$ation
!JAA&a#a &ayat
&o matayenAAa#
7er+ai-ed.
DJ
Jo## of
inde)enden%e
Ja%& of
moti7ation
J#edomy ta&
Diagno#i#:
,i#& for #"i%ide
reated to
de)re##ion
/re#en%e of #ei-"re
Co6 #ef:e#teem
De)re##ion
,i#& for #"i%ide
!*DJAfter 8
ho"r# of
effe%ti7e
n"r#ing
inter7ention
the %ient 6i
ma&e a
de%i#ion that
#"i%ide i# not
the an#6er to
the )er%ei7ed
)ro+em
C*DJ After 24
ho"r# of
n"r#ing
inter7ention
the %ient 6i
+e in7o7ed in
)anning
%o"r#e of
a%tion to
%"rrent
e9i#ting
)ro+em and
identify %"rrent
fa%tor# that he
%an +e
deaing.
D9:
J$#ta+i#hed ra))ort
JA##e##ed
%"rrent heath #tat"#
JNoted +eha7ior#
indi%ati7e of intent
JNoted age and gender
J,e7ie6ed famiy
hi#tory for #"i%ida
+eha7ior
J*o )ro7ide tr"#t
for the )atient
JNote e9i#ting
)o##i+iity of
)ro+em#
JMany )eo)e
#igna their intent,
)arti%"ary to
heath%are
)ro7ider#
J,i#& for #"i%ide
i# greater in
mae#, teen#,
and the edery
+"t there i# a
ri#ing a6arene##
of ri#& in eary
%hidhood
J>ndi7id"a ri#& i#
in%rea#ed,
e#)e%iay 6hen
the )er#on 6ho
%ommitted
#"i%ide 6a# %o#e
!*DJGoa met,
After 8 ho"r# of
effe%ti7e n"r#ing
inter7ention the
%ient 6a# a+e to
ma&e a de%i#ion
that #"i%ide i# not
the an#6er to the
)er%ei7ed )ro+em.
C*DJ Goa met,
After 24 ho"r# of
n"r#ing
inter7ention the
%ient 6a# a+e to
+e in7o7ed in
)anning %o"r#e of
a%tion to %"rrent
e9i#ting )ro+em
and identify %"rrent
fa%tor# that he %an
+e deaing.
Page 25 of 31
*9:
JDe7eo)ed thera)e"ti%
n"r#e:%ient
reation#hi), )ro7iding
%on#i#tent %aregi7er.
JA##i#ted the %ient +y
he)ing to identify more
a))ro)riate
#o"tion#/+eha7ior
J>dentified %ondition#,
#"%h a# a%"te or
%hroni% +rain
#yndrome, )ani% #tate,
and hormona
im+aan%e
J/ro7ided dire%tion# for
a%tion# %ient %an ta&e,
a7oiding negati7e
#tatement#, #"%h a# Mdo
not#N
JMaintained
o+#er7ation of %ient
and %he%& en7ironment
to the %ient
J/romote# #en#e
of tr"#t, ao6ing
indi7id"a to
di#%"## feeing#
o)eny
J*o e##en #en#e
of an9iety and
a##o%iated
)hy#i%a
manife#tation
JMay interfere
6ith a+iity to
%ontro o6n
+eha7ior and 6i
re@"ire #)e%ifi%
inter7ention# to
)romote #afety
J/romote# a
)o#iti7e attit"de
J*o in%rea#e
%ient #afety or
red"%e ri#& of
Page 26 of 31
for ha-ard# that %o"d
+e "#ed to %ommit
#"i%ide
$d9:
J$n%o"raged
e9)re##ion of feeing#
and ma&e time to i#ten
to %on%ern#
J$m)ha#i-e the
in7o7ement of the
famiy/!D<#= in )anning
im)"#i7e
+eha7ior
JA%&no6edge#
reaity of feeing#
and that they are
o&ay. 3e)#
indi7id"a #ort o"t
thin&ing and
+egin to de7eo)
"nder#tanding of
#it"ation and oo&
at other
aternati7e#
J*o im)ro7e
"nder#tanding
and #"))ort
Page 27 of 31
&IV. 4ischar#e Plan
4ischar#e Plannin# "ctivity and 6ife Style=
Oo" #ho"d get )enty of #ee) and try to &ee) a# reg"ar a #%hed"e a# )o##i+e. *ry to
a7oid too m"%h #tre##. Mo#t )eo)e 6ith #ei-"re# %an ha7e a 7ery a%ti7e ife#tye. /an
ahead for the )o##i+e danger# of a %ertain a%ti7ity. A7oid any a%ti7ity 6here o## of
%on#%io"#ne## 6o"d +e dangero"# "nti it i# %ear that #ei-"re# are "ni&ey to o%%"r. ?ear
a medi%a aert or >D +ra%eet. *e famiy mem+er#, friend#, and the )eo)e yo" 6or& 6ith
a+o"t yo"r #ei-"re di#order.
Medication=
Ne7er #to) ta&ing any #ei-"re medi%ine# 6itho"t ta&ing 6ith yo"r do%tor. Do not #to)
ta&ing yo"r #ei-"re dr"g# ;"#t +e%a"#e yo"r #ei-"re# ha7e #to))ed. Do not #&i) a do#e.
Get yo"r refi# a# #oon a# yo" %an +efore yo" r"n o"t. 'ee) #ei-"re medi%ine# in a #afe
)a%e, a6ay from %hidren. !tore medi%ine# in a dry )a%e, in the +otte that they %ame in.
*hro6 a6ay a od +otte#. !ei-"re dr"g# ha7e #ide effe%t#. >f yo" #tarted ta&ing a ne6
dr"g re%enty, or yo"r do%tor %hanged the do#e of yo"r #ei-"re dr"g, the#e #ide effe%t#
may go a6ay. A6ay# a#& yo"r do%tor a+o"t the #ide effe%t# yo" may ha7e and ho6 to
manage them.
4iet=
A )atient# #ho"d maintain a heathy diet, in%"ding )enty of 6hoe grain#, fre#h
7egeta+e#, and fr"it#. >n addition, dairy food# may +e im)ortant to maintain %a%i"m e7e#.
.a#ting ha# +een "#ed to )re7ent #ei-"re# #in%e an%ient time#. >n the 1921#, a high:fat,
no:#"gar, o6 )rotein diet, &no6n a# a &etogeni% diet, 6a# "#ed to )re7ent #ei-"re#.
,e#ear%her# are in7e#tigating 6hether the At&in# diet <high )rotein, o6 %ar+ohydrate= may
he) )eo)e 6ith e)ie)#y. Both the &etogeni% diet and the At&in# diet %an interfere 6ith
#ome anti:e)ie)ti% medi%ation# #"%h a# to)iramate. *a& to yo"r do%tor +efore +eginning
any #)e%ia diet or a 6eight o## )rogram.

EM8(I8%"6 "%4 PS7CH868GIC S5PP8'(=
Many )atient# 6ith e)ie)#y and )arent# 6ho#e %hidren ha7e e)ie)#y %an +enefit from
#"))ort a##o%iation#. *he#e #er7i%e# are "#"ay free and a7aia+e in mo#t %itie#. Be%a"#e
of the ri#&# for #erio"# emotiona %on#e@"en%e#, )#y%hoogi%a thera)y may +e he)f".
(ogniti7e +eha7iora thera)y offer# a #tr"%t"red %o"n#eing )rogram that he)# )eo)e
%hange +eha7ior# a##o%iated 6ith #ei-"re trigger#, #"%h a# an9iety and in#omnia.
&V. Concl$sions and 'ecommendation
$)ie)#y management ta&e# )a%e in the o"t)atient #etting, a #mooth tran#ition from the
Page 28 of 31
ho#)ita to the %ini% i# e##entia. .or )atient 6ho ha7e #tarted ne6 anti%on7"#ant#
medi%ation, had anti%on7"#ant# do#e# %hanged, or %hanged other medi%ation# that might
intera%t 6ith their anti%on7"#ant#, the timing o the foo6:") 7i#it #ho"d +e di%tated +y the
do%tor. /atient# my need to +e %o"n#eed +o"t #afety i##"e# and im)ortan%e of
medi%ation %om)ian%e.
"ctivity and 6ifestyle
Oo" #ho"d get )enty of #ee) and try to &ee) a# reg"ar a #%hed"e a# )o##i+e. *ry to
a7oid too m"%h #tre##. Ma&e #"re yo"r home i# #afe to he) )re7ent in;"rie# if a #ei-"re
ta&e# )a%e:
'ee) yo"r +athroom and +edroom door# "no%&ed. 'ee) the#e door# from +eing
+o%&ed.
*a&e #ho6er# ony. Do not ta&e +ath# +e%a"#e of the ri#& of dro6ning d"ring a
#ei-"re.
?hen %oo&ing, t"rn )ot and )an hande# to6ard the +a%& of the #to7e.
.i yo"r )ate or +o6 near the #to7e in#tead of ta&ing a of the food to the ta+e.
,e)a%e a ga## door# either 6ith #afety ga## or )a#ti%.
Mo#t )eo)e 6ith #ei-"re# %an ha7e a 7ery a%ti7e ife#tye. /an ahead for the )o##i+e
danger# of a %ertain a%ti7ity. A7oid any a%ti7ity 6here o## of %on#%io"#ne## 6o"d +e
dangero"# "nti it i# %ear that #ei-"re# are "ni&ey to o%%"r.
!ome #afe a%ti7itie# in%"de ;ogging, aero+i%#, %ro##:%o"ntry #&iing, dan%ing,
tenni#, gof, hi&ing, and +o6ing. Game# and )aying in gym %a## or on the
)aygro"nd are generay o&ay.
*here #ho"d a6ay# +e a ifeg"ard or +"ddy )re#ent 6hen yo" go #6imming.
?ear a hemet d"ring +i&e riding, #&iing, and other #imiar a%ti7itie#.
A#& yo"r do%tor a+o"t )arti%i)ation in %onta%t #)ort#.
A7oid a%ti7itie# 6here ha7ing a #ei-"re 6o"d )"t yo" or #omeone e#e in danger.
?ear a medi%a aert or >D +ra%eet. *e famiy mem+er#, friend#, and the )eo)e yo" 6or&
6ith a+o"t yo"r #ei-"re di#order. Dri7ing yo"r o6n %ar i# generay #afe and ega on%e the
#ei-"re# are %ontroed. Dn%e a #ei-"re #tart#, there i# no 6ay to #to) it. .amiy mem+er#
and %aregi7er# %an ony he) ma&e #"re yo" are #afe from f"rther in;"ry. *hey %an a#o %a
for he), if needed.
?hen a #ei-"re #tart#, famiy mem+er# or %aregi7er# #ho"d try to &ee) yo" from faing.
*hey #ho"d he) yo" to the gro"nd, in a #afe area. *hey #ho"d %ear the area of f"rnit"re
or other #har) o+;e%t#. (aregi7er# #ho"d a#o: ("#hion yo"r head. Coo#en tight %othing,
Page 29 of 31
e#)e%iay aro"nd yo"r ne%&. *"rn yo" on yo"r #ide. >f 7omiting o%%"r#, t"rning yo" on yo"r
#ide he)# ma&e #"re yo" do not inhae 7omit into yo"r "ng#. !tay 6ith yo" "nti yo"
re%o7er, or )rofe##iona medi%a he) arri7e#. Mean6hie, %aregi7er# #ho"d monitor yo"r
)"#e and rate of +reathing <7ita #ign#=.
*hing# yo"r friend# and famiy mem+er# #ho"d not do:
DD ND* re#train <try to hod do6n= the )er#on.
DD ND* )a%e anything +et6een the )er#onP# teeth d"ring a #ei-"re <in%"ding
yo"r finger#=.
DD ND* mo7e the )er#on "ne## they are in danger or near #omething ha-ardo"#.
DD ND* try to ma&e the )er#on #to) %on7"#ing. *hey ha7e no %ontro o7er the
#ei-"re and are not a6are of 6hat i# ha))ening at the time.
DD ND* gi7e the )er#on anything +y mo"th "nti the %on7"#ion# ha7e #to))ed
and the )er#on i# f"y a6a&e and aert.
DD ND* #tart (/, "ne## the #ei-"re ha# %eary #to))ed and the )er#on i# not
+reathing or ha# no )"#e.
Concl$sion
>n %on%"#ion Generai-ed toni%:%oni% <G*(= #ei-"re# <formery %aed grand ma #ei-"re#=
"#"ay are not diffi%"t to diagno#e. *he o## of %on#%io"#ne## "#"ay o%%"r#
#im"taneo"#y 6ith the on#et of a generai-ed #tiffening of fe9or or e9ten#or m"#%e# <the
toni% )ha#e=. After the toni% )ha#e, generai-ed ;er&ing of the m"#%e# <%oni% a%ti7ity=
o%%"r#. A G*( #ei-"re i# amo#t a6ay# foo6ed +y dee) )o#ti%ta #ee).
!ome )atient# may ha7e a #im)e )artia #ei-"re <a"ra= )re%eding the o## of
%on#%io"#ne##. *hi# indi%ate# that the on#et of the #ei-"re i# o%ated in a imited area. A#
the #ei-"re #)read# in the %orte9, the #ei-"re de7eo)# into a G*( #ei-"re. *hi# ty)e of
#ei-"re i# %a##ified a# a #im)e )artia #ei-"re 6ith #e%ondary generai-ation.
Many )atient# 6ith generai-ed toni%:%oni% #ei-"re# ha7e 7i#ion, ta#te, #me, or #en#ory
%hange#, ha"%ination#, or di--ine## +efore the #ei-"re. *hi# i# %aed an a"ra. *he
#ei-"re# "#"ay in7o7e rigid m"#%e#, foo6ed +y 7ioent m"#%e %ontra%tion#, and o## of
aertne## <%on#%io"#ne##=.
Mo#t )eo)e 6ith e)ie)#y i7e a f" ife #)an. 3o6e7er, there are )otentia fa%tor#
a##o%iated 6ith i7ing 6ith e)ie)#y and #ei-"re# that may in%rea#e the ri#& of in;"ry or
"ntimey death. /eo)e 6ith e)ie)#y m"#t ta&e %ertain )re%a"tion# to red"%e the ri#& of
Page 30 of 31
in;"ry d"ring a #ei-"re.
&VI. 6ist of 'eferences
Medi%a:!"rgi%a n"r#ing 12
th
$dition Br"nner and !"ddarth
By !"-anne (. !met-er, Brenda G. Bare , 0ani%e C. 3in&e, and 'erry 3. (hee7er
N"r#e#A# /o%&et G"ide 12
th
$dition
By Mariynn $. Doenge#, Mary .ran%e# Moorho"#e, Ai%e (. M"rr
Da7i#A# Dr"g G"ide for N"r#e# 12
th
$dition
By 0"dith 3ofter Degin, A)ri 3a-ard Baerand, (ynthia A. !ano#&i
."ndamenta# of N"r#ing 5th $dition
Page 31 of 31
By 0o#ie Q"iam+ao:Kda
Anatomy and /hy#ioogy >nternationa !t"dent Ber#ion *ortora and Derri%&#on
?e+#ite:
666.6e+md.%om < $)ie)#y !ei-"re *y)e# and !ym)tom#=
666.nm.nih.go7 <!ei-"re#=