Pathophys behind seizure post head injury

i've got the pathophysiology from two books. if you read and put the information from both together you pretty much have the whole picture.

pathophysiology: the biologic basis for disease in adults and children, third edition, by kathryn l. mccance and sue e. heuther gives the pathophysiology for a tonic-clonic seizure. i'm just going to copy it right out of the book because i have to read their stuff over 10 times along with a medical dictionary to finally get a light bulb to switch on. i'll just type and let you do the thinking! it is from page 472:

in later pages, the authors ascribe the seizures of brain injuries to compression as a result of either bleeding or swollen tissues.

pathophysiology: a 2-in-1 reference for nurses by springhouse, springhouse publishing company staff has this to say about seizure disorder (pages 330-331):

i have both books. it depends on how in depth you want to go. the mccance and heuther book is quite large, physically, with over 1600 pages and covers just about everything. i can't pick it up with one hand. it is required for most bsn and master's level classes, i do believe. it is straight pathophys and includes just as i copied it with signs and symptoms (clinical manifestations) and evaluation and treatment for most of the diseases it does address. it has no specific nursing interventions although some might be mentioned. it has charts and illustrations. as i said, i sometimes have to read things over a few times to understand them. when i was answering someone's question on the pathophysiology of the inflammatory response it took me about 4 hours of reading through various paragraphs before i finally "got it" all straight so that i could come up with a nice analogy for it. but, then again, inflammation and allergy response is complicated anyway. there is a newer edition out now and the cost is around $90+.

pathophysiology: a 2-in-1 reference for nurses was written for students. it is organized by body systems and covers the major diseases within each body system. for each there is a description of the disease, causes, the pathophysiology that, i think, is a little easier to read and understand with notes off to the margin titled "how it happens", signs and symptoms, complications, diagnosis (tests done to determine the disease), treatment and nursing considerations (specific nursing interventions to that disease). in some cases, they have broken the manifestations (signs and symptoms) of the pathophysiology down by body system which is really helpful--they do it in the section on renal failure. the book has charts, diagrams and two sections with color plates. i particularly like the step-by-step explanation that it gives for the progression of heart failure, something that is often a great mystery and difficult to understand. this book is part of a series; the other 3 are on assessment, pharmacology and signs & symptoms. i have the assessment and signs & symptoms books. they all kind of coordinate with each other--what i mean is that a lot of the same information is in them if it is appropriate to the subject of the book. the cost of these books is around $45. i am finding that i like the signs & symptoms book because it has some information on what to assess for, as well as treatment, which can be turned into nursing interventions, when confronted with a specific sign or symptom. very helpful with writing care plans on medical patients. it also gives you the specific medical diseases that a symptom is known to be a component of. sorry if i digressed a bit here.

Sounds cool. I'd get my hands on as many clinical pathways as I could. A clinical pathway is just another style of a written care plan merged with nursing notes. One thing any care plan does do is memorialize in writing the critical thinking that goes into the problem solving of the nursing problems on that particular plan of care. There is no law or formal mandate by any accrediting organization that NANDA must be used as the way to identify nursing problems. The only requirement is that there is a care plan [Medicare Conditions of Participation 42CFR482.23(b)(4)] and that it be a part of the patient's medical record [JCAHO Comprehensive Accreditation Manual for Hospitals Standard IM 6.20, Elements of Performance 1]:

• 42CFR482.23(b)(4) - The hospital must ensure that the nursing staff develops, and keeps current, a nursing care plan for each patient.
  
• JCAHO, Standard IM 6.20 - Records contain patient-specific information, as appropriate, to the care, treatment, and services provided. Elements of Performance 1. Each medical record contains, as applicable, the following clinical/case information: All reassessments and plan of care revisions, when indicated.

The choice to use nursing diagnoses, and specifically NANDA's nursing diagnosis taxonomy, is a decision made by each facility. Before NANDA we simply wrote out patient problems and they were often just symptoms. It took a group of smarty pants (sorry if I'm making it sound snotty) to say, "you know, I'm having to write the same interventions for this group of problems. Since they are all related, why don't we group them together and put one label on them and save ourselves a lot of repetitive writing." And, NANDA was born and changed our lives forever. The idea of NANDA was to standardize all this writing of problems on care plan forms. Why sit there and have to think about the way to word these things? That's what we had to do pre-NANDA. NANDA has pretty much done all the wording for you. But, if people weren't told that or never figured this out, they'll tell you how much they hate it. They should have been around back in 1970. NOC has given us outcomes and NIC the interventions that merge with the NANDA diagnoses. Added bonus is they can be programmed into a computer and you can just check the stuff off on a computer screen. We didn't have computers back in the 70's either and hand wrote all care plans.

The clinical pathways are no different, just a different format that sometimes incorporates NANDA diagnoses and sometimes doesn't. But it always reflects that the nursing process is being done and that a plan of care has been activated.

At the foundation of them all, however, is the nursing process which, as I constantly write, is nothing more than how we solve the problem using our tools of the nursing profession. Know the steps of the nursing process and what you have to do at each step and you can walk into any nursing facility and write a care plan using whatever crazy format they want you to use.

1. Assessment (collect data from medical record, do a physical assessment of the patient, assess ADL's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   
2. Determination of the patient's problem(s)/Nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
   
3. Planning (write measurable goals/outcomes and nursing interventions)
   
4. Implementation (initiate the care plan)
   
5. Evaluation (determine if goals/outcomes have been met)

Have fun working on your scenarios! There is a summary of threads with pathophysiology information collected together on it here: https://allnurses.com/forums/2634117-post49.html