Epilepsyis a chronic and neurological medical condition that affects thebrain and the nervous system. The symptoms of Epilepsy entailunprovoked and frequent seizures that emanate from the brain. Thedisorder affects 1% of the world’s population. Intellectualdisability is a developmental disorder characterized by the lack ofeducational and functional skills relative to a person’s age. Thedisability occurs when one experiences early suffering in life thathampers a person’s development. Patients with intellectualdisability have an IQ of less than 70. Women face more difficultiescompared to their male counterparts diagnosed with intellectualdisability and epilepsy. The challenges emanate from hormonalinfluences that increase the rate and magnitude of seizures (Sankar,2013).
Thefirst health challenge on the woman is increased seizures. Seizuresare caused by a reduction in the supply of blood to the brain causedby the hardening and narrowing of the blood vessels that take bloodto the brain. Consequently, it reduces the circulation of oxygen intothe brain. Intellectual disability increases the rate and duration ofseizures. It increases the complexity of seizures, and the patientcan experience more than one type of seizures simultaneously. Theincreased complexity of seizures reduces the nurse’s ability todetermine the specific type of seizure experienced by the patient.Consequently, the patient is forced to use multiple anti-epilepticdrugs that lead to multiple side effects. Seizures become morepainful after menopauses due to hormonal changes that take place in awoman’s body. Consequently, the diagnosis of epilepsy is moredifficult due to the development of critical phenomenologies(Medford, 2014).
Second,the woman experiences other health challenges such as limitedabilities in cognition. Epilepsy with intellectual disability limitsthe patient`s ability to recognize feelings, objects and people.Besides, the patient may have problems with language andcommunication. Consequently, it is hard for the woman to explain hercondition without the help from her career (Jones-Gotman, &Banks, 2013).
Thethird health challenge is bone health. Aged women with epilepsies areassociated with lower bone mineral to density ratio. When womenapproach menopause, they begin to experience bone loss. Besides,women diagnosed with epilepsy and intellectual disability are proneto risks of fractures, osteopenia, and osteoporosis. The bone losscondition requires consideration when administering theAnti-Epileptic Drugs (AEDs). The drugs increase the rate of bone losswhen administered to female patients. Patients diagnosed withEpilepsy and intellectual disability is associated with highmorbidity and mortality rates (Jones-Gotman, & Banks, 2013).
ConcerningICF, the woman is limited to participation and activity due to herhealth condition. First, patients with epilepsy and intellectualdisability cannot find employment. Their intellectual disabilityhampers their productivity at work. Besides, epilepsy leads tochances of unpredicted seizures. Consequently, the patient isrequired to be under the constant watch of her caretaker.
Second,the woman’s mobility is restricted. Patients with epilepsy are notallowed to engage in unmonitored mobility. First, due to epilepsy,patients are required to have someone watching by their side.Besides, her intellectual disability implies that she is notperfectly self-aware. Consequently, she is only allowed to movewithin surroundings that are familiar to her.
Dueto intellectual disability, the patient is limited to the use ofpublic means of transport and taxis, they have to be escorted bysomeone. Besides, the woman is forbidden to participate in physicalactivities. Her caretaker might limit her participation within theexternal environments of her home. The limitation emanates from thecarers fear of seizures.
Thereis the need for the nurse to come up with various interventions suchas managing the patient’s medication, modifying her diet andcontrolling her day-to-day risk exposure. Besides, the patient’scondition requires additional interventions inform of relaxationtherapy, first aid and epilepsy education for those close to her.
Thefirst intervention strategy entails management of the patient’sdrug taking policy. The strategy should aim to reduce the frequencywith which the patient is expected to take the drugs. Decreasing thefrequency of medication intake increases the effectiveness of themedication. Specifically, it enables the patient to recall when theyare required to take their medication.
Regardingthe application of medication, nurses should recommend theappropriate anti-epileptic drugs after the second seizure. The firstseizure is not proof enough for epilepsy (Medford, 2014). The choiceof the patient’s drugs shall depend on factors such as age andother medication recommended to the patient in the past. Nurses areadvised to consider the possibility of a patient’s pastprescription to react with anti-epileptic drugs beforerecommendation. I will start the woman on a small dose ofanti-epileptic drugs and will increase the dose within the patient’ssafety limits. I will test the various AEDs on the patient until Ican identify the particular AED based on outcomes. I shall advise thepatients’ caretaker not to give her any additional medicine duringthe period she is on AEDs. I shall also monitor the various sideeffects such as drowsiness, lack of energy, headaches, tremors, hairloss or uncontrolled hair growth, swollen gums and rashes (Korff,2015).
Thesecond strategy entails the managing the patient`s diet. I shallprescribe the patient to a ketogenic diet. A ketogenic diet iscomposed of high-fat foods such as eggs, bacon, mayonnaise, butter,heavy whipping cream, and oils. Besides, vegetables, fruits, nuts,avocados, olives, and cheese are important dietary additions forepileptic patients. I shall ensure that the patient has access toenough fluids by recommending her intake of dietary soda and flavoredwaters. Fluids are necessary to prevent the adverse effects caused bythe medicine (Jehi, 2013).
Thethird strategy entails risk management of the patient’s day-to-dayactivities. The first step is to monitor the patients encounter withwater. Patients with epilepsy and intellectual disabilities are moresusceptible to drown in pools. Consequently, it is important tomonitor the patient’s movements around pools. Besides, bathroomsshould be installed with anti-slip mats to reduce injuries in case ofseizures. Other strategies involve the installation of fire alarmsand fireguards in the homestead. Besides, the electricity systemshould have a circuit breaker (Jehi, 2013)..
Thefourth strategy to risk management entails training the patient’scommunity on first aid procedures upon the occurrence of seizures. Ishall inform them that the tremors during seizures last for a maximumof five minutes failure to which, there is the need to call anambulance. I shall also train the community on how to remove anyharmful objects near the patient, and how to place the patient`s headon a soft surface (Contin et al., 2012).
Epilepsy with intellectual disability posesvarious health challenges to the patients. Specifically, epilepsyleads to seizure and bone health challenges while intellectualdisability leads to communication challenges. Seizures are caused byinsufficient blood supply to the brain due to the hardening andnarrowing of blood vessels with age. The resultant insufficientsupply of oxygen results in periodical brain failure. Intellectualdisability leads to increased effects of seizures for epilepsypatients. Specifically, the patients encounter frequent seizures thatare of varied nature. The increased variety of seizures reduces thechances for effective diagnosis by healthcare personnel and lowersthe effectiveness of the medication.Bone health emanates from thetendency of women to experience a decline in the number of bones withage. The association of Anti-Epilepsy Drugs with increased rates ofbone loss dictates the prescription on elderly women. Epilepsyresults in reduced participation and activity rates among patients.Specifically, they cannot engage in sports, employment or other highenergy demanding activities. The inability to get employment causesfinancial constraints to the patients (Korff, 2015).
Aneffective strategy for handling epileptic and intellectually disabledpatients entails the patient’s medication, dietary modifications,day-to-day risk management, relaxation therapy, first aid andepilepsy education. Factors such as age and previous medication ofthe patient assist in the prescription of the appropriateAnti-Epileptic Drugs (AED’s). Reducing the frequency by which apatient should take medication increases the ability of the patientto remember taking the pills and increases the effectiveness of themedication. Dietary management of the patient encompasses energy andfat foods such as bacon as well as vegetables. Fruits and fluidsreduce the effect of the drugs (Medford, 2014).
Therisk management of the patient focuses on reducing the effect ofpatient’s falls upon the occurrence of seizures. There is a needto train the community about the necessity for therapy on a patient.Therapy reduces anxiety, depression and anger or more than one of thefactors that cause seizures in epilepsy. Therapy is necessary becausethe patient’s thoughts guide their feelings and actions.Consequently, to change the patient’s feelings there is a need tochange their thinking (Mula, 2013).
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