Risk Factors (Modifiable) Hypertension, Sedentary Lifestyle, Kidney Problems

Risk Factors (NonModifiable) Age(75) Gender(Female)

Vascular Resistance Activity of RAAS

Use of Diuretics LSLF Diet

Impaired Filtration Mechanism

GFR

Renal Function Inability to dilute urine

Creatini ne

Inadequate Intake of Sodium

Osmolality of ECF ECF diluted ICFconcentrated

CKD
Build up of fluid & waste products

RBC

Uremi a Salt wastin g

RBC prod

H2O moves into cells -Osmosis

Impaire d renal excretio n of H2O

HYPONATREMIA

Swelling of Cells Neurons

Altered ability to depolarize & repolarize Lethargy, confusion, SEIZURES, irritability Nervous System

Etiology -An electrical disturbance in the nerve cells in one section id the brain causing hypoxemia them to emit abnormal recurring, uncontrolled electrical discharges Factors -Injury, Infections, alcohol,

Early S/S -peculiar taste in the mouth, blurry vision, may hear a non existent musical sound, numbness or weakness, headache, disoriented, anxiety, Dizziness. Nausea, light headedness

Late S/S -LOC, confusion, difficulty talking, shaking, stiffening

Predisposing -idiopathic (genetic, developmental defects) -acquired vascular insufficiency, fever (childhood),hypertemsi on, CNS, metabolic and toxic, brain tumor, drug and withdrawal, and allergies

Cellular/Metabolic Changes
-when the integrity of the neuronal cell membranes is altered, the cell begins firing with increased frequency and amplitude. When the intensity discharges reaches threshold, the neuronal firing spreads to adjacent neurons, ultimately resulting to seizure. Inhibitory neurons in epilepsy have slow neuronal firing in the cortex, anterior thalamus, and basal ganglia. Once the inhibitory processes develop or the epileptogenic neurons are exhausted, the seizure stops then later events depress the CNS activity and impair consciousness.

Gross Anatomical Physical Changes -Involuntary

Physiologic Manifestations

movements my spread centrally and involve the entire limb, including one side of the face and lower extremities, the client also may exhibit changes in posture or spoken utterances

Epigastric sensation, pallor, sweating, flushing, pupillary dilation, tachycardia and tachypnea
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S/S Tonic Phase: a Fall, loss of consciousness, yell or tonic cry, extension of arms, legs and/or face, fingers and jaw clenched. Autonomic symptoms include increase in BP, HR Clonic Phase: Muscles relax completely then muscle tone returns which causes rhythmic jerking of head and body. Post-ictal Phase: biting of tongue, cheek or lip, and urinary incontinence are common

Laboratory Findings

-MRI may detect lesions in the brain, focal abnormalities, and central degenerative changes -EEG may allow diagnosis of the type and location of the occurring seizure

SEIZUR E

Complications -Hypotoxic brain damage and mental retardation may follow repeated seizures -Depression and anxiety may develop. Long term social isolation