Ch. 13: Seizures Pt. 2-Care and Complications of Seizures Flashcards
What are seizure precautions we need to initiate for any child at risk?
- Pad side of bed, crib, and wheelchair
- Keep bed free of objects that could cause injury
- Have suction and oxygen equip available
During seizure, if patient has seizure on floor what do we do?
Hold head in lap
During seizure..what position is best?
A position that maintains a patent airway & turn client to side to decrease risk of aspiration
During seizure..is it ok to restrain the child for safety?
NO do not attempt to restrain the child!
Is it ok to open the jaw during the seizure or insert an airway?
No!! This may damage teeth, lips, or tongue
T/F: Using padded tongue blades helps prevent damage to the oral cavity during a seizure
FALSE; do not use padded tongue blades during a seizure
If a patient wears glasses and they are having a seizure, should we leave them on or take them off?
Take off
During seizure. What should we note?
- Onset
- Time
- Characteristics
During seizure..How should we allow the seizure to end?
Spontaneously
Post-seizure. What position and why?
Side-lying…to prevent aspiration and to facilitate drainage of oral secretions
What injuries should we asses for?
All types, but don’t forget to include the mouth (tongue and teeth)
Post-seizure: What should we note?
Time of postictal period
Do we remain with client during seizure?
Yes
Do we remain with client after seizure?
Yes
Post seizure: When is it ok to administer food or liquid?
When the client is completely awake and swallow reflex is present
Post seizure: What should we determine?
If client experience an aura –which may indicate the origin of seizure in the brain
What class of drugs are given for seizures?
Anti epileptic drugs (AED)
What are examples of antiepoleptic drugs?
Diazepam Phenytoin Carbamazepine Valproic acid Fosphenytoin sodium
Client education about meds?
- TAKE AT SAME TIME EVERY DAY to enhance effectiveness
- Be aware of food interactions
- Teach adverse effects
What is a ketogenic diet?
High fat
Low carb
Adequate protein
What are some surgical interventions for seizures (4)?
- Removal of tumor, lesion, or hematoma
- Focal resection of an area of the brain to remove epileptogenic zone
- Hemispherectomy: Removal of one hemisphere of brain
- Corpus callostomy: Separation of two hemispheres in brain
VNS (vagal nerve stimulation): Where is the stimulation implanted and where is it connected?
Implanted: left chest wall
Connect to: An electrode that is placed at the LEFT vagus nerve
How does VNS work to control seizures?
Device is programmed to administer intermittent VNS at rate specific to clients needs
The client may initiate VNS by holding a magnet over device at onset of seizure activity–this will either abort seizure or lessen its severity
What lab tests should be periodically monitored?
AED (antiepiletic drugs)
Inform the client about possible medication interactions. Ex?
The AEDs can cause decreased effectiveness of oral contraceptives!
What are some complications?
Status epilepticus
Developmental delays
Status epliepticus (SE): Seizure activity that lasts longer than ____ OR a _____ activity in which client DOES NOT enter a postictal phase
Longer than 30 MIN or a CONTINUOUS seizure
*this acute condition requires immediate treatment to prevent loss of brain function
SE: Nursing actions?
- Maintain airway
- Adminsite O2
- Get IV access
- Do ECG monitoring
- Monitor Pulse Ox and ABG
SE: As prescribed, administer a loading dose of ____ or _____. If seizure continues after loading dose is given ____ followed by ____ should be administer
SE: As prescribed, administer a loading dose of DIAZEPAM or LORAZEPAM. If seizures continue after the loading dose is given, FOSPHENYTOIN followed by PHENOBARBITAL should be administered
A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following should be included in discussion? (SATA)
A. VNS B. Additional AED meds C. Corpus callostomy D. Focal resuction E. Radiation theapy
A, B C, D
