Encephalopathy

Definition

Encephalopathy is a generic term for any diffuse disease or disorder that alters brain function, most often producing altered mental status. It is typically reversible with treatment of the underlying cause.

Types

• Hepatic encephalopathy: Ammonia accumulation in cirrhosis, such as asterixis, altered LOC, coma.
• Hypertensive encephalopathy: Severe BP elevation with cerebral edema.
• Uremic encephalopathy: Renal failure.
• Wernicke's encephalopathy: Thiamine deficiency, such as ataxia, ophthalmoplegia, confusion.
• Septic encephalopathy: Severe infection.
• Toxic/metabolic encephalopathy: Drugs, electrolyte imbalance, hypoglycemia.

Nursing Interventions

Treat underlying cause (lactulose for hepatic, dialysis for uremic, thiamine for Wernicke's). Frequent neuro checks, safety precautions, seizure precautions, ensure nutrition. Provide family support.

NCLEX Relevance

Classic hepatic encephalopathy care: lactulose for 2 to 3 soft stools/day to trap ammonia.