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NUR 202 > Chapter 15 Seizures > Flashcards

Chapter 15 Seizures Flashcards

1
Q

Seizure

A

-disturbance of electrical activity in the brain that may affect consciousness, motor activity, and sensation
- caused by abnormal or uncontrolled neural charges (Foci, Focus,or spread)
- symptom of underlying disorder, not diagnosis
-SINGLE OCCURENCE

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2
Q

Can you have a seizure w/o convulsions?

A

Yes

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3
Q

Can hypoglycemia cause seizure activity

A

Yes, brain love glucose

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4
Q

Epilepsy

A

Neurological disorder
- two or more occurrence of seizures; seizures occurring chronically
-people have periods of seizure activity
-characterized by recurrent symptoms that may include blackouts, fainting spells, sensory disturbances, jerking body movements, and temporary loss of memory

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5
Q

Convulsions

A

-ALWAYS mean seizure activity
- all convulsions are seizures but not all seizures are convulsions
- INVOLUNTARY, violent spasms of large skeletal muscle of the face, neck, arms, and legs
-localized twitching

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6
Q

T or F: over 50% of seizures are idiopathic: no specific cause can be identified

A

True

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7
Q

Known causes of seizures (6)

A

-Fever
-Infectious disease
-Metabolic disorder
-Neoplastic disease
-Trauma
- Vascular disorder

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8
Q

Fever: cause of seizures

A

Rapid increase in body temperature may cause febrile seizures seen in infants and toddlers

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9
Q

Metabolic disorders: cause of seizure

A

Changes in fluid and electrolyte levels
Hypoglycemia, hyponatremia, water intoxication, may cause seizures by alternating electrolyte impulse transmission at cellular level

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10
Q

Infectious diseases: cause of seizure

A

Acute infections such as meningitis or encephalitis, can cause inflammation to the brain

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11
Q

Neoplastic disease: cause of seizure

A

Tumor, especially rapidly growing ones, can occupy space, increase intracranial pressure and destroy brain tissue by distrusting blood flow

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12
Q

Trauma: cause of seizure

A

Physical trauma such as blows to the head can increase in trace animal pressure; chemical trauma from presence of toxic substances from ingesting poison, causing brain injury

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13
Q

Vascular disease: cause of seizure

A

Changes in oxygenation (respiratory hypoxia, CO poisoning)

Changes in perfusion (HYPOtension, shock, seizure, cardiac dysrhythmias)

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14
Q

Why is pregnancy planning a concern for women w/ epilepsy

A

several AED decrease effectiveness of hormonal contraceptives

pregnancy category D

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15
Q

General classification for seizures (3)

A

1) partial (focal)
-seizure activity starts in one part of the brain
2) generalized (spread)
- consciousness is lost at onset
-seizure activity involves the whole brain
3) special epileptic syndromes

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16
Q

Two types of partial seizures

A

1) simple partial
2) complex partial (psychomotor)

17
Q

Simple partial

A
  • olfactory, auditory, visual hallucination
  • intense emotion
  • twitching of arms, legs, face
  • jerking, deja vu,
    -alert
    -nausea
    -strange taste or smell
18
Q

Complex partial (psychomotor)

A
  • altered awareness and behavior
  • repetitive movements, cognition
    -PRECEDING AURA
  • no response to verbal
    -brief period of confusion or sleepiness after w/ no memory of seizure (postural confusion)
19
Q

List Generalized seizures

A

1) absence (petit mal)
2) atonic (drop attacks)
3) tonic-clonic (grand mal)

20
Q

Can a partial seizure be generalized

A

Yes, a complex or simple can become tonic clonic

21
Q

Absence seizures

A

Few seconds
Trance like state
Petit mal
Misdiagnosed with ADHD or daydreaming

22
Q

Atonic seizures

A

Drop attack or abrupt fall
Stiffening (tonic) or loss of muscle tone (atonic)
Few seconds
Stumbling or falling for no reason

23
Q

Tonic clonic (grand mal)

A

-preceding aura
-tonic: intense muscle contraction
-clonic: alternating contraction and relaxation of muscles
- shallow breathing with apnea (1-2 min)
-disorientation and deep sleep after seizure (postictal state)
-Incontinence
-crying at the beginning as air leaves lung
-LOSS OF CONSCIOUSNESS with convulsion, stiffening of body then jerking of limbs

24
Q

List Special epileptic syndromes

A

1) febrile seizures
2)myoclonic seizures
3)Status epilepticus

25
Q

Febrile Seizures

A

Tonic clonic activity 1-2 min
Children ages 3 months to 5 years
Rapid return to consciousness

26
Q

Myoclonic seizures

A

Sudden large jerking movements
Falling from sitting position or dropping what is held

27
Q

Status epilepticus

A

Medical emergency
Continuous seizure activity; can lead to death or coma
>30 min
2 or more seizures without full recovery of consciousness
give IV diazepam

28
Q

Treatment for status epilepticus

A

IV diazepam

29
Q

MOA of diazepam, class, onset, contraindications, interventions, AE

A

Potential effects GABA (increase influx of Cl-)
Benzodiazepine
Effects in minutes, anticonvulsant effects last 20 min
Contraindications: alcohol, shock, coma, depressed vital signs,
Interventions: monitor respirations every 5-15 min, have airway and resuscitate equipment available

AE hypotension, tachycardia, muscular weakness, respiratory depression

30
Q

Phenytoin (Dilantin), lab monitoring, abrupt withdrawal

A

Hydantoin
MOA: inhibit influx of Na
Monitor blood glucose level; may increase blood glucose serum level
Monitor DM patients closely
Risk for hepatotoxicity
Abrupt withdrawal—> status epilepticus

31
Q

Phenobarbital (Luminal)

A

Barbiturate
Potentiate GABA
- increase GABA in CNS—> decrease neuron firing, suppress seizure activity
GABA —> primary inhibitory neurotransmitter in brain

32
Q

Goal of seizure activity

A

Suppress neuronal activity just enough to prevent abnormal focus from forming or spreading across cerebrum

Directed at controlling the movement of electrolytes across neuronal membranes or affecting neurotransmitter balance

33
Q

Phenobarbital AE, how to assess

A

Barbiturate
Common SE: drowsiness, vitamin deficiencies (vitamin D, folate (b9), b12), laryngospasms (makes it hard to speak or breathe)
Overdose: coma, death, severe respiratory depression, CNS depression

Monitor patients condition
Liver and kidney function
Excessive signs of bleeding
Drowsiness and bone pain

34
Q

Phenytoin AE

A

Dysrhythmias (Bradycardia, ventricular fib)
SEVERE HYPOTENSION
Hyperglycemia
Multiple blood dyscrasias (disorder): agranulocytosis (low WBC), aplastic anemia (bone marrow aphasia, bone stops producing enough new blood cells)

NUR 202 (7 decks)

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