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St. Eliza Nursing and Midwifery Training School

17 Mar

St. Eliza Nursing and Midwifery Training School

St. Eliza Nursing and Midwifery Training School

is informing to the general public that The MAY intake interviews will be held on 10th March 2014, starting at 9:00 a.m.

Admissions are going on, you can bring your daughter or son or relative

 

OUR MOTTO

Quality Training for quality Health Service Providers

CORE VALUES

  • Discipline
  • Team work
  • Innovation
  • Devotion
  • Integrity
  • Reliability

OUR PHILOSOPY

To Love and Serve the Nation

THE MISSION STATEMENT

To train dynamic, competent and proficient Nurses and Midwives

THE VISION

To establish Nursing Institution with all Nursing Programmes

PURPOSE

To impart knowledge, technical skills and positive attitudes to promote quality health care

 

For more Details, click at this link

http://sirsamuel.webs.com/apps/blog/show/7058332-enrolled-nursing-and-midwifery-admissions-and-interviews-in-progress-at-st-eliza-nursing-and-midwifery-training-school

Aside 25 Jan

11.7. EPILEPSY
A discrete recurrent abnormality in electrical
activity of the brain, resulting in behavioural, motor
or sensory changes. There may be associated
changes in consciousness.
Causes
􀁺 Idiopathic
􀁺 Brain infections
􀁺 Brain trauma
􀁺 Metabolic disorders, eg. hypoglycaemia
􀁺 Congenital malformation, brain tumour
Clinical features
􀁺 Will depend on the type of epilepsy:
Grand mal
􀁺 May commence with a warning sensation in the
form of sound, light or abdominal pain (aura)
􀁺 There may be a sharp cry followed by loss of
consciousness and falling
􀁺 Tonic contraction of muscles occurs followed by
jerking movements (clonic phase)
􀁺 There may be urinary incontinence, frothing and
tongue biting
􀁺 A period of deep sleep follows
􀁺 Episodes of mental confusion may follow
(post-ictal psychosis)
Petit mal
􀁺 Mainly a disorder of children
􀁺 The attack is characterized by a brief loss of
consciousness (5-10 seconds) in which posture is
retained but other activities cease
􀁺 The child has a vacant stare
􀁺 Previous activities are resumed at the end of the
attack
􀁺 Several attacks may occur in a single day
11. Neurological/Psychiatric conditions
UCG 2010 235
Complex–partial seizures (Temporal lobe
epilepsy)
􀁺 Has varied symptoms
􀁺 Signs of autonomic nerve dysfunction, i.e.
sweating, flushing and gastric sensation
􀁺 Mental confusion with perceptual disorders
(illusions, hallucinations), memory loss or
distortion, mood variation, abnormal repetitive lip
movement, automatism.
Focal epilepsy
􀁺 Fits begin with motor contraction or sensory
change in a particular point of the body such as
the thumb.
Myoclonus epilepsy
􀁺 Abnormal jerking movements occur usually in the
limbs but may involve the whole body.
Status epilepticus
􀁺 Convulsive state in which the seizure lasts >30
minutes or several epileptic seizures occur in
succession without recovery of consciousness in
between.
Differential diagnosis
􀁺 Syncope
􀁺 Hypoglycaemia
􀁺 Migraine
􀁺 Hypocalcaemia
􀁺 Conversion disorder
􀁺 Hyperventilation and panic attacks
Investigations
􀂾 Electroencephalogram (EEG)
– useful in petit mal and temporal lobe epilepsy
􀂾 X-ray: skull
􀂾 Other investigations are guided by suspected
cause.
11. Neurological/Psychiatric conditions
UCG 2010 236
Management (depends on type of epilepsy)
Petit-mal
􀁦 ethosuximideinitially 500mg daily in 2 divided doses
– increase if necessary by 250mg every 4-7 days
up to a usual daily dose of 1-1.5g
child >6 yrs: as above
<6 yrs: initially 250mg single dose at night
increased gradually as required to usual
20mg/kg daily in 2 divided doses
Grand-mal
􀁦 phenytoin initially 3-4mg/kg (150-300mg) daily
as single dose or 2 divided doses
− increase gradually prn to usual 200-500mg daily
or carbamazepine
initially 100-200mg 1-2 times HC4
daily increased prn in 100mg increments every 2
weeks to usual 800-1,200mg daily in divided doses
or phenobarbitone 60-180mg at night HC4
child:
􀁦 phenytoin initially 5mg/kg daily in 2 divided
doses HC3
− usual range: 4-8mg/kg daily, max: 300mg daily
or carbamazepine 10-20mg/kg daily
in at least 2 divided doses
or phenobarbitone 8mg/kg daily
Temporal lobe epilepsy
􀁦 carbamazepine – doses as for Grand mal above
Focal epilepsy
􀁦 phenytoin – doses as for Grand mal above
Myoclonic epilepsy
Management as for focal epilepsy
Status epilepticus
􀁦 diazepam 10mg rectally child <4: 5mg
– repeat once prn after 5 mins
or diazepam 10-20mg slow IV (5mg/min)
– repeat once prn after 30-60 mins
11. Neurological/Psychiatric conditions
UCG 2010 237
child: 200-300 micrograms/kg IV or IM per dose
Note:
􀂋 Diazepam: in serious cases of status epilepticus,
doses of 20-40mg, titrated to individual patient
response, may be needed
􀂋 Treatment should always continue until patient is
seizure-free for at least 2 years then gradually
taper off the doses
Prevention
􀁺 Good antenatal care and delivery
􀁺 Control causative factors