Beth - Week 7 - Exam 3

Question 1

what is a seizure?

Answer 1

uncontrollable; excessive firing of hyperexcitable neurons

Question 2

what is epilepsy?

Answer 2

recurring sezures

Question 3

why do seizures occur?

Answer 3

abnormal foci in the brain; a symptom of pathology; don’t know why; could be head injury to stroke, meningitis → seizure → infections in brain

Question 4

T/F if the entire cerebral cortex is involved → unconscious

Answer 4

YES TRUTH

Question 5

what are the risk factors for seizures? look at case study also

Answer 5

• idiopathic
• birth trauma; congenital
• sensory overload (flashing)
• head trauma; tumor
• meningitis; encephalitis
• hyperthermia
• metabolic (electrolyte imbalance/hypoglycemia/stroke)
• CVA
• drug and/or ETOH withdrawal

Question 6

what are the classifications of seizures?

Answer 6

generalized or partial (new) focal

Question 7

what is a one generalized seizure called?

Answer 7

tonic - clonic (grand mal)

Question 8

what are the sxs of tonic - clonic seizures?

Answer 8

• Aura-may or may not feel it coming
• Loss of consciousness
• Tonic movement
• Clonic movement
• B & B incontinence
• Tongue biting
• Salivation
• Post-Ictal Phase

Question 9

what are the sxs of a T-C seizure post ictal phase?

Answer 9

H/A, sore, tired, amnesia, difficulty to arouse

Question 10

what is another generalized seizure called?

Answer 10

absence (petite mal)

Question 11

what are the sxs of an absence seizure?

Answer 11

• Interruption of consciousness
• Seen in pediatrics
• Staring spells
• “vacant stare`
• Altered awareness or loss of environmental
contact

Question 12

what are the characteristics of a partial (focal) simple seizure?

Answer 12

• No loss of consciousness
• Motor: Single muscle group progressing to
adjacent muscle groups
• Sensory-senses
• Autonomic
• Déjà vu

Question 13

what are the characteristics of a partial (focal) complex seizure “temporal lobe epilepsy” “pysychomotor”?

Answer 13

• 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

Question 14

who is most susceptible to a febrile seizure?>

Answer 14

• young children with high temps

Question 15

what is the treatment for febrile?

Answer 15

tylenol, tepid bath, IV/rectal if vallium necessary

Question 16

what is the nursing role for seizures?

Answer 16

• Risk Factors
• Patient Assessment
• Patient Safety
• Ongoing Assessment

Question 17

what is the medical management for all types of seizures?

Answer 17

• 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

Question 18

what are the anti-epileptic drugs that are voltage-dependent sodium channels?

Answer 18

Carbamazepine
Phenytoin
Lamotrigine
Oxcarbazepine
Zonisamide
Lacosamide
Rufinamide
Eslicarbazepine

Question 19

what are the anti-epileptic drugs that affect GABA activity?

Answer 19

Phenobarbital
Tiagabine
Vigabatrin
Benzodiazepines

Question 20

what are the anti-epileptic drugs that have multiple mechanisms of action?

Answer 20

Valproate
Felbamate
Topiramate

Question 21

what are the anti-epileptic drugs that have other mechanisms of action?

Answer 21

Gabapentin
Pregabalin
Levetiracetam
Brivaracetam
Ezogabine

Question 22

what is the surgical management for seizures?

Answer 22

• Local resection
• Temporal lobectomy
• Implanting a pulse generator
• Vagal Nerve Stimulator

Question 23

what is the diagnostic study for seizures?

Answer 23

electroencephalogram (EEG)
• Detects electrical activity in the brain
• Brain cells communicate via electrical impulses which show as wavy lines on a graph

Question 24

what are the nursing considerations for an EEG?

Answer 24

• 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

Question 25

what is status epilepticus?

Answer 25

a medical emergency - prolonged seizure w/o regaining consciousness for at least 30 minutes

Question 26

what do you see during status epilepticus?

Answer 26

• increased metabolic demand
• venous congestion
• brain hypoxia

Question 27

what are the precipitating factors for status epilepticus?

Answer 27

• withdrawal of epileptic drugs
• fever
• infection
• imbalance in glucose or electrolytes?

Question 28

what is the management of status epilepticus?

Answer 28

• 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

Question 29

what is the family teaching for status epilepticus?

Answer 29

• 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

Question 30

what are the lifestyle modications for status epilepticus?

Answer 30

• adequate sleep
• avoid ETOH; talk to MD about OTC drugs
• use relaxation techniques
• awareness of aura
• awareness of emotional disturbances