Beth - Week 7 - Exam 3 Flashcards
what is a seizure?
uncontrollable; excessive firing of hyperexcitable neurons
what is epilepsy?
recurring sezures
why do seizures occur?
abnormal foci in the brain; a symptom of pathology; don’t know why; could be head injury to stroke, meningitis → seizure → infections in brain
T/F if the entire cerebral cortex is involved → unconscious
YES TRUTH
what are the risk factors for seizures? look at case study also
- idiopathic
- birth trauma; congenital
- sensory overload (flashing)
- head trauma; tumor
- meningitis; encephalitis
- hyperthermia
- metabolic (electrolyte imbalance/hypoglycemia/stroke)
- CVA
- drug and/or ETOH withdrawal
what are the classifications of seizures?
generalized or partial (new) focal
what is a one generalized seizure called?
tonic - clonic (grand mal)
what are the sxs of tonic - clonic seizures?
- Aura-may or may not feel it coming
- Loss of consciousness
- Tonic movement
- Clonic movement
- B & B incontinence
- Tongue biting
- Salivation
- Post-Ictal Phase
what are the sxs of a T-C seizure post ictal phase?
H/A, sore, tired, amnesia, difficulty to arouse
what is another generalized seizure called?
absence (petite mal)
what are the sxs of an absence seizure?
• Interruption of consciousness • Seen in pediatrics • Staring spells • “vacant stare` • Altered awareness or loss of environmental contact
what are the characteristics of a partial (focal) simple seizure?
• No loss of consciousness • Motor: Single muscle group progressing to adjacent muscle groups • Sensory-senses • Autonomic • Déjà vu
what are the characteristics of a partial (focal) complex seizure “temporal lobe epilepsy” “pysychomotor”?
• Has impaired level of consciousness • Simple → Complex • Unaware • Bizarre behavior - Lip smacking - Automatism or automatic movement - consistent - look like looking actively but it's automatic
who is most susceptible to a febrile seizure?>
- young children with high temps
what is the treatment for febrile?
tylenol, tepid bath, IV/rectal if vallium necessary
what is the nursing role for seizures?
- Risk Factors
- Patient Assessment
- Patient Safety
- Ongoing Assessment
what is the medical management for all types of seizures?
• Goal: Prevention and Protection • Assess seizure for type & duration (before, during, after) • Protect from injury (public or hospital) • Administer anti-epileptic drugs • check serum drug levels • Assess and Reassess
what are the anti-epileptic drugs that are voltage-dependent sodium channels?
Carbamazepine Phenytoin Lamotrigine Oxcarbazepine Zonisamide Lacosamide Rufinamide Eslicarbazepine
what are the anti-epileptic drugs that affect GABA activity?
Phenobarbital
Tiagabine
Vigabatrin
Benzodiazepines
what are the anti-epileptic drugs that have multiple mechanisms of action?
Valproate
Felbamate
Topiramate
what are the anti-epileptic drugs that have other mechanisms of action?
Gabapentin Pregabalin Levetiracetam Brivaracetam Ezogabine
what is the surgical management for seizures?
- Local resection
- Temporal lobectomy
- Implanting a pulse generator
- Vagal Nerve Stimulator
what is the diagnostic study for seizures?
electroencephalogram (EEG)
• Detects electrical activity in the brain
• Brain cells communicate via electrical impulses which show as wavy lines on a graph
what are the nursing considerations for an EEG?
- no caffeine
- Make sure pt eats
- Withold tranquilizers if a sleep deprived EEG
- Can the pt. have their anticonvulsants?—when should you give them?
- No sedations
what is status epilepticus?
a medical emergency - prolonged seizure w/o regaining consciousness for at least 30 minutes
what do you see during status epilepticus?
- increased metabolic demand
- venous congestion
- brain hypoxia
what are the precipitating factors for status epilepticus?
- withdrawal of epileptic drugs
- fever
- infection
- imbalance in glucose or electrolytes?
what is the management of status epilepticus?
• Adequate oxygenation • may intubate if airway compromised • Start/monitor an IV • Control the seizure activity with \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ • Protect from injury • Administer anti-epileptic drugs as ordered • check serum drug levels • Assess and Reassess
what is the family teaching for status epilepticus?
• When can pt. drive? - seizure free for a year • Oral care • Showers not tub bath • Take meds daily to keep drug levels up • Blood samples • teach risk factors • Life style modifications • Make sure meds are regulated • Women can have healthy babies • ID tags with name of drugs • Resources • Compliance • Discuss the issue of not being overprotective
what are the lifestyle modications for status epilepticus?
- adequate sleep
- avoid ETOH; talk to MD about OTC drugs
- use relaxation techniques
- awareness of aura
- awareness of emotional disturbances
