409 1 Flashcards
Seizures may cause alterations in
LOC and motor changes
Epilepsy
chronic recurring abnormal brain electrical activity
_____ seizures are more common in children and tend to occur in families.
Absence
Acute febrile state is a seizure risk factor especially for
infants and children younger than the age of 2 years
how can Metabolic disorders cause Sz
the disorder can cause imbalance in chemicals in the brain
Sz Triggering Factor: excess intake of
caffeine
A generalized seizure is also called a
tonic-clonic seizure
A 1- to 2-min clonic episode (which is _________) follows the tonic episode
rhythmic jerking of the extremities
Sz: _____ can accompany breathing irregularities.
Cyanosis
Absence seizure consists of
a loss of consciousness lasting a few seconds.
This type of seizure is associated with blank staring.
Absence
Seizure activity also may include unconscious, involuntary behavior associated with eye
fluttering, smacking of the lips, and picking at clothes called automatisms
Absence
Myoclonic seizures consist of
brief jerking or stiffening of the extremities, which may be symmetrical or asymmetrical
Atonic or akinetic seizures are characterized by
a few seconds in which muscle tone is lost.
type of Sz where the loss of muscle tone frequently results in falling
Atonic or akinetic
Partial or focal/local seizure include
Complex partial seizure
Simple partial seizures
Complex partial seizures have associated
automatisms (behaviors that the client is unaware of, such as lip smacking or picking at clothes)
Amnesia may occur immediately prior to and after the seizure
Complex partial seizures
Sz where consciousness is maintained throughout
simple partial seizures
Sz position
turn on their side to prevent aspiration
Try to control seizure activity using medication such as
phenytoin
When should antiepileptic drugs be taken
same time everyday
When using ____, specific instructions should include avoidance of oral contraceptives
phenytoin
___ should also not be given with phenytoin
Warfarin (Coumadin)
Some antiepileptic medications cause oral gum overgrowth. What can minimize this side effect
oral hygiene
vagal nerve stimulator treats
Sz
vagal nerve stimulator: In addition to routine stimulation, the client may initiate vagal nerve stimulation by
holding a magnet over the implantable device, at the onset of seizure activity
vagal nerve stimulator: avoid
MRI, Ultrasound, microwave
Status epilepticus
prolonged seizure activity occurring over a 30-min time frame
what are the meds you’d give someone while they’re Sz’ing
loading dose of diazepam or lorazepam
then a continuous infusion of phenytoin
Parkinson’s 4 main symptoms
tremor
muscle rigidity
bradykinesia (slow movement)
postural instability
Parkinson’s symptoms occur due to overstimulation of the basal ganglia by
acetylcholine
Treatment of PD focuses on increasing the amount of _____ or decreasing the amount of _____
increasing DA
decreasing Ach
Parkinson’s risk factor: exposure to
toxins and chemicals
Parkinson’s risk factor: Gender
male
Parkinson’s risk factor: Chronic use of
antipsychotic medication
Parkinson’s gait
slow, shuffling
Parkinson’s diagnostic procedures
None. Rather the dx is based on symptoms, their progression, and by ruling out other diseases
Parkinson’s meds may take several
weeks of use before improvement
Dopaminergics may be combined with carbidopa (Sinemet) to decrease peripheral metabolism of levodopa requiring a smaller dose to make the same amount available to the brain. Side effects are
subsequently less
If a Parkinson’s patient is using an anticholinergic, monitor for side effects like
dry mouth
constipation
urine retention
Catechol O-methyltransferase (COMT) inhibitors can be used to treat
Parkinson’s
Catechol O-methyltransferase (COMT) inhibitors: a normal finding is
dark urine
amantadine is used to treat
Parkinson’s
amantadine: monitor for
swollen ankles and discoloration of the skin
Deep brain stimulation is tx for
Parkinson’s
Deep brain stimulation: The client will need to be instructed on how to
use a magnet to adjust the current
Deep brain stimulation: The client will need to be instructed on how to use a magnet to adjust the current. The battery to the magnet will need to be replaced every
few years
As PD advances in severity, alterations in chewing and swallowing will worsen, increasing the risk for
aspiration
A chronic disorder of recurrent seizures
Epilepsy
Abnormal neuronal activity may remain localized, causing a partial or focal seizure, or it may spread to involve the entire brain, causing
generalized seizure activity
Primary Sz
Idiopathic (repeated episodes with no known cause)
Seizures caused by febrile seizures in children, toxemia of pregnancy, rapid withdrawal from alcohol or barbiturates, systemic metabolic conditions (hypoglycemia, E- imbalances)
Secondary
Metabolic needs of the brain during seizure activity
increase dramatically
Partial Seizures
Involve activation of only a restricted part of one cerebral hemisphere
a simple partial seizure in which there is
no alteration in consciousness
Complex partial seizures
consciousness is impaired and the client may engage in repetitive, non-purposeful activity, such as lip smacking, aimless walking, or picking at clothing (automatisms)
Seizures that involve both hemispheres of the brain as well as deeper brain structures: thalamus, basal ganglia, and upper brainstem
Generalized Seizures
Sudden brief cessation of all motor activity accompanied by a blank stare and unresponsiveness.
Absence seizures
Absence seizures: kind of movements that may occur
lip-smacking or eyelid fluttering may occur
Clonic Phase is characterized by
alternating contraction and relaxation of the muscles in all the extremities along with hyperventilation.
Seizure activity becomes continuous, with only very short periods of calm between intense and persistent seizures
Status Epilepticus
Status Epilepticus: what kind of IV fluid would you give
50% glucose administered intravenously to prevent hypoglycemia
Phenytoin must be administered in
Normal Saline
Barbiturate administered to clients in status epilepticus
Phenobarbital
The most common cause of epilepsy in older adults is
arteriosclerosis of the cerebrovascular system
Older adults tend to have longer
post-seizure manifestations than do younger people
Of note, some ____ decrease the effect of statins
AEDs
Epilepsy that begins in older adults in often easier
to control with anti-epileptic drugs (AEDs) than that in younger people
Causes gingival hyperplasia
phenytoin
Blood levels of phenobarbital may rise significantly when _____ is added to the client’s medication regimen
valproic acid
Sz pt diet consideration
avoid alcohol
limit coffee
Sz pt hygiene consideration
Showers instead of tub baths
