409 1 Flashcards by Richard smith

Seizures may cause alterations in

LOC and motor changes

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Epilepsy

chronic recurring abnormal brain electrical activity

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_____ seizures are more common in children and tend to occur in families.

Absence

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Acute febrile state is a seizure risk factor especially for

infants and children younger than the age of 2 years

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how can Metabolic disorders cause Sz

the disorder can cause imbalance in chemicals in the brain

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Sz Triggering Factor: excess intake of

caffeine

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A generalized seizure is also called a

tonic-clonic seizure

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A 1- to 2-min clonic episode (which is _________) follows the tonic episode

rhythmic jerking of the extremities

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Sz: _____ can accompany breathing irregularities.

Cyanosis

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Absence seizure consists of

a loss of consciousness lasting a few seconds.

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This type of seizure is associated with blank staring.

Absence

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Seizure activity also may include unconscious, involuntary behavior associated with eye
fluttering, smacking of the lips, and picking at clothes called automatisms

Absence

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Myoclonic seizures consist of

brief jerking or stiffening of the extremities, which may be symmetrical or asymmetrical

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Atonic or akinetic seizures are characterized by

a few seconds in which muscle tone is lost.

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type of Sz where the loss of muscle tone frequently results in falling

Atonic or akinetic

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Partial or focal/local seizure include

Complex partial seizure

Simple partial seizures

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Complex partial seizures have associated

automatisms (behaviors that the client is unaware of, such as lip smacking or picking at clothes)

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Amnesia may occur immediately prior to and after the seizure

Complex partial seizures

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Sz where consciousness is maintained throughout

simple partial seizures

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Sz position

turn on their side to prevent aspiration

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Try to control seizure activity using medication such as

phenytoin

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When should antiepileptic drugs be taken

same time everyday

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When using ____, specific instructions should include avoidance of oral contraceptives

phenytoin

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___ should also not be given with phenytoin

Warfarin (Coumadin)

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Some antiepileptic medications cause oral gum overgrowth. What can minimize this side effect

oral hygiene

vagal nerve stimulator treats

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