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NURS 2514 > Chapter 7 Seizures > Flashcards

Chapter 7 Seizures Flashcards

1
Q

Explain action potential in connection with neuron excitability and conduction

A

Occurs when the resting potential stimuli reaches a certain point (depolarize (becomes more +)

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2
Q

What are the 6 steps of membrane potential?

A
  1. Na+ channels open, Na+ begins to enter
  2. K+ channels open, K+ begins to leave the cell
  3. Na+ channels become refractory, no more Na+ enters cell
  4. Na+ channels become refractory, no more Na+ enters cell
  5. K+ channels close, Na+ channels reset
  6. Extra K+ outside diffuses away
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3
Q

What is does the sodium-potassium pump do?

A

Moves K+ out and Na+ into the cell

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4
Q

What is membrane resting potential? What is the Voltage of the cell at that time?

A

When cells are not excited. -70V to -85V (less negative)

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5
Q
  1. What is action potential?

2. What is the minimum voltage?

A
  1. When stimuli exceeds the resting membrane potential.

2. +30V is the minimum needed for an action potential

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6
Q

What is depolarization?

A

When the cell undergoes an electric shift in electric charge distribution, resulting in less negative charge inside the cell compared to the outside

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7
Q

What is repolarization?

A

Refers to the change in membrane potential that returns it to a negative value just after the depolarization phase of an action potential which has changed the membrane potential to a positive value

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8
Q

How does calcium play a role on membrane potential?

A
  1. Opens up as membranes become depolarized

2. Allows influx of Ca+ into the cell

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9
Q

What is the role of neurotransmitters?

A

Molecules used by the nervous system to transmit messages between neurons, or from neurons to muscles.

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10
Q

What are the 2 outcomes of neuron excitability and conduction?

A
  1. Neuron plasma membrane becomes excited + depolarizes

2. Causes plasma to be inhibited

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11
Q

What is involved in the presynaptic and postsynaptic neuron?

A
  1. Axon terminal: Synaptic vesicle, voltage-gated Ca++ channels
  2. Synaptic cleft: Neurotransmitters
  3. Postsynaptic neuron: Neurotransmitter receptors
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12
Q

What are the two neurotransmitters and what do they do? What is needed from neurotransmitters?

A
  1. Glutamate: Activates postsynaptic receptors, causing an influx of Na+, increasing the likelihood that an action potential will be generated.
  2. GABA (gamma-aminobutyric acid): Activates postsynaptic receptors, causing an influx of K+, inhibiting the likelihood that an action potential will be generated.
  3. Balance is required from neurotransmitters
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13
Q

Define seizure and what is caused by

A

An uncontrolled electrical discharge of neurons in the brain that interrupts normal function that is caused by a chronic underlying pathology

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14
Q

Define epilepsy and the cause

A

A condition in which at least two spontaneous seizures occur more than 24 hours apart. Exact cause is unknown.

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15
Q

What are the metabolic disturbances of seizures?(6)

A
  • Acidosis
  • electrolyte imbalance
  • hypoglycemias
  • hypoxia
  • alcohol & barbiturate withdrawal
  • dehydration
  • water intoxication
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16
Q

What are the age groups at risk for seizures?

A

<6 Months old, 2-20 years old, 20-30 years old, and >50 years old

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17
Q

What are the causes of seizures for those who are <6 months old?

A

Severe birth injury, congenital defects, infections

18
Q

What are the causes for seizures who are 2-20 years old?

A

Birth injury, infection, trauma, genetics

19
Q

What are the causes for seizures who are >50 years old?

A

Stroke, metastatic brain tumors

20
Q

What is the general cause for seizures?

A

Anything that can cause brain irritation

Eg. Anything that causes brain hypoxia, brain swelling, changes to cells of the brain, and infection.

21
Q

What are the 4 stages of seizures?

A
  1. Prodrome Phase
  2. Aura Phase
  3. Ictal Phase
  4. Postictal Phase
22
Q

What are the manifestations of the prodrome phase?

A

Changes in mood

  • anxiety
  • difficulty sleeping
  • behavioural changes
  • light headaches or dizziness
23
Q

What are the manifestations of the Aura Phase

A
  • Sensory warning
  • nausea
  • headache
  • smells weird scents (burnt toast)
  • weird taste in mouth
  • strange sounds
  • dizziness
  • visual changes
  • panic and fear
24
Q

What are the manifestations of the Ictal Phase

A
  • Loss of awareness
  • difficulty hearing
  • odd smell, taste & sound
  • difficulty speaking or saying words
  • twitching
  • loss of muscle control
  • repeated movements
  • body convulsions
  • Increase in HR & difficulty breathing
25
Q

What are the manifestations of seizures in the Postictal Phase?

A
  • Confusion - some will remember their seizure, some will not
  • exhaustion - extremely tired
  • headache
  • fear and anxiety
  • sore muscle and weakness (throughout the body)
  • shame
  • injuries from seizure
26
Q

What seizure stage is the start of the seizure to the end?

A

Ictal Phase

27
Q

Name the three seizure classifications

A
  1. Generalized
  2. Tonic-Clonic
  3. Focal Seizure
28
Q

Define and give examples of a generalized seizure

A

Definition: Bilateral synchronous epileptic discharges in brain from the onset of the seizure
Example: Tonic-clonic, absence, atonic, and myoclonic seizure

29
Q

What are the warnings for generalized seizures? What does the patient experience?

A
  • Because the entire brain is affected, there is usually no warning signs or Aura.
  • Patient experiences losing consciousness for a few seconds to minutes
30
Q

Describe Tonic-Clonic seizure phases

A
  • Tonic phase: stiffening of body for 10-20 secs

Clonic phase: jerking of extremities for 30-40 secs

31
Q

Characterize Tonic-Clonic seizure and patient experience

A
  • Characterization: Loss of consciousness and falling to the ground if patient is upright
  • Cyanosis, biting of tongue and cheek, incontinence, and excessive salivation often occur
  • Patient experience: Exhausted after tonic-clonic seizure with extreme muscle soreness
  • No memory of seizure
32
Q

Manifestation of Focal Seizure

A
  • Unilateral, affecting area of the brain with abnormal excitation
  • May begin as focal seizure and eventually convert into the entire brain being involved (can go to a generalized seizure)
33
Q

What is the cause of focal seizures?

A

Electrical activity in the focal part of the brain

34
Q

Identify the key difference between a seizure and epilepsy

A

Seizure: Uncontrolled electrical discharge, will not stop after treatment
Epilepsy: 2 or more seizures within 24 hours

35
Q

What are the common causes of seizures?

A
  1. Dehydration
  2. Electrolyte imbalance
  3. Acidosis
  4. Hypoxia
  5. Water intoxication
  6. Hypoglycaemia
  7. Alcohol & barbiturate withdrawl
36
Q

Describe the two main classifications of seizures

A
  1. Generalized seizure: Bilateral, entire brain affected

2. Focal seizure: Localized affected, can lead to general seizure

37
Q

Describe the tonic-clonic seizure, how does it look?

A

Patient loses consciousness or falls to the ground while upright. Stiffening of the body for 10-20 seconds followed by jerking of extremities for 30-40 secs. Cyanosis, excessive salivation, tongue & cheek biting, and incontinence may accompany seizure. Patient will feel tired & experience soreness after the episode.

38
Q

List and define 5 of the consequences of Seizures

A
  1. Aspiration: Risk of choking, airway (mouth foaming & tongue biting)
  2. Impaired gas exchange: Loss of consciousness and brain is too excited we worry if enough O2
  3. Injury: Falling, protect patient from injury
  4. Quality of life: Mental health, stigmatization, long time worry
  5. Mental health: Depression, anxiety can increase seizure through sleep deprivation
39
Q

Define and describe severity of Status Epilepticus

A

State of continuous seizure activity and is a medical emergency (extreme situation)

40
Q

Describe brain status consequences of status epilepticus

A

Brain is in a hypermetabolic state - demand is greater than supply which can lead to hypoxemia, acidosis, hyperthermia, respiratory failure, and cardiac arrest

NURS 2514 (11 decks)

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