Ações de enfermagem no cuidado à lactente com síndrome de WEST: um relato de caso / Acciones de enfermería en el cuidado de los bebés con síndrome de WEST: un informe de caso / Actions of nursing care in the infant with WEST syndrome: a c ase report

Objective: Systematizing nursing care to an infant with West Syndrome, using the Nomenclature of Diagnoses/Results and Nursing Interventions. Methods: A descriptive study, of case type study, conducted in a teaching hospital in João Pessoa/Paraíba in October 2010, following the phases of the nursing process. The diagnoses were identified using the Nomenclature of Diagnoses/Results and Nursing Interventions developed and validated for the referred hospital as terms of ICNP ®. The project was approved by the Research Ethics Committee of the hospital, under CAAE: 0052.0.126.000-09. Results: There were identified six nursing diagnoses: psychomotor impairment, seizures, impaired oral hygiene, respiratory pattern changes, risk of infection, family routine changed. Conclusion: The use of a classification of diagnoses /results and interventions directs nursing actions for efficiency in the care of children with West syndrome.

Objetivo: Sistematizar a assistência de enfermagem a uma lactente com Síndrome de West utilizando aNomenclatura de Diagnósticos/Resultados e Intervenções de Enfermagem. Métodos: Estudo descritivo, do tipo estudo de caso, realizado em um Hospital Escola em João Pessoa/Paraíba em outubro de 2010, seguindo as fases do processo de enfermagem. Os diagnósticos foram identificados utilizando-se a Nomenclatura de Diagnósticos/Resultados e Intervenções de Enfermagem desenvolvidos e validados para o referido hospital conforme termos da CIPE®. O projeto foi aprovado pelo Comitê de Ética em Pesquisa do hospital, sob CAAE:0052.0.126.000-09. Resultados: Foram identificados seis diagnósticos de enfermagem: comprometimento neuropsicomotor, convulsão, higiene oral prejudicada, padrão respiratório alterado, risco de infecção, rotina familiar alterada. Conclusão: A utilização de uma nomenclatura de diagnósticos/resultados e intervenções direciona as ações de enfermagem, proporcionando eficiência no cuidado a criança com síndrome de West.

Objetivo: Sistematizar la atención de enfermería a un bebé con síndrome de West utilizando la nomenclatura de diagnósticos/resultados y intervenciones de enfermería. Métodos: Estudio descriptivo, del tipo estudio de caso, realizado en un hospital universitario en João Pessoa/Paraíba, en octubre de 2010, siguiendo las fases del proceso de enfermería. Los diagnósticos fueron identificados con la nomenclatura de diagnósticos/resultados y intervenciones de enfermería desarrollados y validados para el hospital como términos de CIPE®. El proyecto fue aprobado por el Comité de Ética de Investigación del hospital, bajo CAAE: 0052.0.126.000-09. Resultados: Se identificaron seis diagnósticos de enfermería: deterioro neuropsicomotor, convulsiones, higiene oral deficiente, cambios en los patrones respiratorios, riesgo de infección, la rutina familiar cambiada. Conclusión: El uso de una clasificación de diagnósticos/resultados e intervenciones dirige las acciones de enfermería para la eficiencia en el cuidado de los niños con síndrome de West.

Levetiracetam.

The incidence of neonatal seizures varies according to gestational age, weight, and cause. Seizures occur in an estimated 1.0-3.5 per 1,000 term infants1 with an increased incidence of 10-130/1,000 in preterm infants.2 Most neonatal seizures have a specific cause.3 Hypoxic-ischemic encephalopathy has been identified as the most common etiology associated with neonatal seizures, accounting for 50-60 percent of the cases.4 Table 1 outlines common causes of neonatal seizures. Early recognition of seizures and appropriate treatment is vital in preventing multiorgan dysfunction and permanent brain damage.

Cuidados de enfermagem a pacientes com Síndrome de West / Nursing care for patients carriers of West Syndrome

Objetivo: compreender a síndrome em debate para elaboração de cuidados ampliados na área da enfermagem pediátricapretendendo fornecer uma atenção direcionada as crianças portadoras da doença. Método: trata-se de um ensaio teóricofundamentado em uma revisão bibliográfica do tipo narrativa, que permite a análise da literatura publicada, artigos derevista impressas e/ou eletrônicas sobre um determinado assunto, com o objetivo de descrevê-lo e discuti-lo, sob ponto devista teórico ou contextual. Resultados: ao término da construção do referencial teórico da síndrome de West, pode-seperceber que a implementação da Sistematização da Assistência de Enfermagem (SAE) era algo imprescindível para aamenização e diminuição do agravo dos sintomas causados pela síndrome de West (SW). Os diagnósticos de enfermagem quepodem ser adotados nos casos de SW são: Mobilidade Física Prejudicada; Risco para lesão; Confusão crônica; Risco parainfecção; Ansiedade Relacionada à morte. Conclusão: a (SAE) é considerada uma estratégia de amplo aspecto quando sefala em assistência integral a esse paciente, e para o portador de SW, a SAE será de grande valia para controle e diminuiçãodos agravos gerados pelos sinais e sintomas.

[Home hospital care for children suffering from serious neurological pathologies]. / L'hospitalisation à domicile des enfants atteints de pathologies neurologiques graves.

The return home of seriously ill very young children causes worry and upheaval in the family. The home hospital care team supports the child and his/her family enabling links to be forged between them, whatever the outcome of the illness, whilst respecting the rhythm of each family member. The situation of Flora, 14 months, illustrates this support.

Seizures in infants and young children: an exploratory study of family experiences and needs for information and support.

An exploratory study of the experiences of parents caring for young children with seizure disorders and their perceived needs for information and support was conducted. A questionnaire and interview protocol was designed to elicit information about the child's seizure history, child and parent health history, medical and support services, child and family demographic information, parent experiences in caring for a young child with seizures, and perceptions about needs for information and support. Interviews were conducted with 31 parents who were recruited from a pediatric neurology clinic at a university hospital. Interviews were audiotaped, transcribed, and analyzed for major themes. The study revealed a broad range of experiences in caring for young children with seizures, and the early onset and severity of seizures often influenced these experiences. Obtaining information that was easily accessible and helped them to better understand their child's diagnosis and treatment was a challenge reported by many parents. In addition, interviews revealed that parents felt a need for support and information from individuals who were knowledgeable about the medical, developmental, emotional, and family issues related to coping with seizures in infants and young children. Recommendations for a comprehensive approach to the management of seizures for infants and young children are proposed, with particular focus on the role of nurses and early intervention professionals in providing information and support to families.

Encefalopatia con hipsarritmia sin espasmos infantiles / Infantile encephalopathy with hipsarritmia without spasms

Los niños con encelopatias cronicas pueden presentar retraso del desarrollo psicomotor y en algun momento de su evolucion, crisis de espasmos con tazado electroencefalografico hipsarritmico, constituyendo un sindrome de west sintomatico. Presentamos un analisis y seguimiento evolutivo de 9 niños que, si presentaron hipsarritmia, no sufrieron espasmos. Prevaleciendo en mujeres (8:1), la hipsarritmia comenzo en la mayoria de los pacientes (77.8 por ciento) antes de los meses. El factor etiologico fue, en todos los pacientes, un daño encefalico previo. Clinicamente los niños presentaron examen neurologico anormal, solo 6 niños presentaron convulciones y ninguno presento crisis de espasmos. Los electroencefalogramas mostraron algun tipo de hipsarritmia. Se evalua el resultado del tratamiento con ACTH instaurado. Resaltamos la existencia de hipsarritmia sin crisis de espasmos y destacamos que 3 niños de nuestra serie presentaron, como caracteristica propia distintiva, la ausencia de manifestaciones convulsivas

Neonatal seizures: the debate continues.

Investigators disagree on the significance of and the best treatment for neonatal seizures. Each year more data are revealed and the controversy continues. A foundation must be laid for discussing this controversy by reviewing neonatal seizure classification and etiology. Neonatal seizures may occur with and without electroencephalogram (EEG) correlation. Although some seizures may not correlate with an abnormal EEG, they may still be a sign of significant brain dysfunction. The nurse's understanding of these principles and the ability to recognize and report these events will enable the neonate to receive the proper care and treatment in the most expedient manner.

Home care management of the child with infantile spasms.

The child with infantile spasms is at considerable risk for side effects related to ACTH therapy. Careful evaluation and assessment skills are essential in managing this group of patients following discharge.

Discharge planning for the child with infantile spasms.

Infantile spasms is a type of seizure disorder usually occurring within the first 24 months of life. The standard treatment is intramuscular injections of repository corticotropin (HP ACTHAR gel). The child with infantile spasms is at risk for developmental delay, even if the seizures are controlled. The parents' grief reaction to this prognosis may affect their ability to learn and implement the treatment plan. Discharge planning for children and families is extensive and must begin at the time of the child's admission to the hospital.