DONE: Disorders: Seizures Flashcards
What does the nurse need to know about Partial seizures?
During this type of seizure they are alert and conscious this is called a simple partial seizure.
Assess:
What type is it?
What occured before, during, and after this event.
Do they have an Aura, lose consciousness, do they fall and how are they afterwards?
These nursing assessment interventions are implemented during what type of neurological disorder?
Seizure
________ is a condition in which a person will have spontaneously reoccurring seizures caused by a chronic underlying condition.
Epilepsy
Confusion
Behavioral
Emotional
Affective and cognitive changes occur during the seizure
The patient is conscious.
This are clinical manifestations of what type of seizure?
Simple Partial seizures
Study Tip: This is the difference between partial and complex is the loss of consciousness.
This type of seizure is a state of continuous seizure or back-to-back seizure that don’t go away. Any seizure activity that lasts longer than 10-15 mins and it requires medical attention.
These are clinical manifestations of what neurological disorder?
Status epilepticus
What are the 7 causes of seizures?
Genetic Trauma Tumors Circulatory disorders Metabolic disorders Toxicity Infections
This type of seizure is a staring spell accompanied by other signs and symptoms and they might have peculiar behavior during the seizure or be confused afterwards
These are clinical manifestations of what neurological disorder?
Atypical absence seizure
ASK ARBOGAST? Small children will sometimes get seizures, but they are normally caused by a ______ NOT epilepsy because most of the time it will just happen 1 time.
What type of seizures is this?
High Temperature
Partial seizure ???
If the patient’s LOC is Alert what type of seizure are they having?
Simple partial seizure
Complex partial seizures affect the patients ______
LOC
Study Tip: The patient will not remember the seizure.
Define Seizures?
Abnormal, sudden, excessive, discharge of electrical activity that spreads within the brain that interrupts normal brain function.
What are the six sub-categories Generalized Seizures?
Seizures can be divided into: Generalized tonic-clonic seizures Absent seizures Myoclonic seizures Tonic seizures Clonic seizures Atonic seizures
Why are Seizure classifications so important?
They are very IMPORTANT because if you have a patient that has a seizure you need to be able to DESCRIBE and DOCUMENT the seizure accurately and be sure what you are telling the health care provider is correct because it will direct the course of treatment.
Both [simple & complex] partial seizures can turn into a _______ seizure.
Generalized
Study Tip: This means that the abnormal neural activity will begin to affect the entire brain instead of just one area of the brain.
If the patient is alert during the seizure, what type of seizure are they having?
Simple partial seizures
Why should the nurse administer OXYGEN and LOOSEN constrictive clothing during a seizure?
The brain can become hypoxic during a seizure.
Study Tip: THIS IS IMPORTANT
Assess:
History: when did they start; head injuries, auras, and previous types that the patient has experienced.
These nursing assessment interventions are implemented during what type of neurological disorder?
Seizure
Finish the Nursing Diagnoses related to Seizures?
Ineffective Breathing Pattern R/T
???
Define a Myoclonic Seizure?
Myoclonic seizures are brief, shock like jerks and a muscle or group of muscles.
Study Tip: Myo- means muscle & Clonus-means rapidly alternating of contraction and relaxation. There is a jerking are twitching of a muscle. Usually don’t last more than a second or two. They can be just one but sometimes many will occur within a short time.
Even people without epilepsy experience Myoclonus in hiccups or in a sudden jerk that may wake you up as you are just falling asleep. These things are normal.
This type of seizure involves both sides of the brain. There is the epileptic/electrical ?discharges from the onset of the seizure and this is because the entire brain is affected. There is no warning or aura with this type of seizure.
What type of seizures is this?
Generalized seizure
Usually the _______ seizures last a minute or less very rarely do they go for a longer period of time.
Simple and complex partial seizures
Atonic Seizure Definition?
These are clinical manifestations of what neurological disorder?
Atonic Seizure
Define Clonic Seizure?
A convulsion with intermittent contractions, the muscles being alternately contracted and relaxed.
Name the two Seizure Classifications? & the difference between them?
Partial Seizures
Generalized Seizures
Partial Seizures can be divided into 2 categories:
Simple partial seizures
THIS PATIENT REMAINS CONSCIOUS!!
Complex Partial seizures > this patient is unconscious
Generalized Seizures can be divided into 7 categories: Generalized tonic-clonic seizures Absent seizures Myoclonic seizures Tonic seizures Clonic seizures Atonic seizures THIS PATIENT LOSES CONSCIOUSNESS!
What is an aura?
An odd feeling a patient will get before an onset of a seizure.
What does the nurse know about a Complex Partial seizures?
During this type of seizure their mental status and LOC is altered.
Define Tonic Seizure?
Convulsion in which the contractions are maintained for a time, as in tetany.
During this type of seizure the patient goes unconscious at the start of the seizure.
What type of seizure is this?
Generalized seizures
It is very important to keep a patient safe during a _______ seizure the patient be unconscious during the seizure and it can be preceded by a partial seizure.
Generalized Tonic-clonic seizure
This type of seizure usually occur in children and rarely continues beyond adolescents; it’s like they are there, but they’re not; they kind of stare off into space.
These are clinical manifestations of what neurological disorder?
Generalized Absence Seizure
This type of seizure is characterized by a loss of consciousness, they fall.
This causes safety to be an issue for this patient, their body stiffens this is the tonic phase > lasts for _____ secs then they start jerking and that is the clonic phase > last another ____ secs
These are clinical manifestations of what neurological disorder?
10-20
30-40
Generalized tonic-clonic seizure
Just having a seizure, unless it’s the first one does not require ________. The first seizure they should be a warning sign and cause the patient to seek help from a medical professional.
medical attention
Monitor this patient for incontinence. They will be incontinent after a ________ seizure.
Generalized tonic-clonic seizure
Assess: Loss of motor function Loss of bowel function Loss of bladder function Loss of consciousness These nursing assessment interventions are implemented during what type of neurological disorder?
Generalized Tonic-Clonic Seizure
During ______ brain electrical activity impulses go to where they are meant to go.
normal
When the patient is standing and having a seizure what is the nurses number one priority?
Place on floor and protect head/body
Do NOT force anything into mouth of a patient having a seizure INCLUDING YOUR FINGERS!!! What would the nurse use instead with a patient having a seizure?
Bite blocks used to be at bedside to prevent them from biting their tongue.
During ______ brain electrical activity impulses go into the deeper structures of the brain and then it also goes to other areas of the brain and there is just uncontrolled electrical firing that can cause a seizure.
Abnormal
How do Anticonvulsants prevent Seizures?
These medications act by stabilizing the nerve cell membranes to decrease electrical activity in the brain.
Study Tip: They are given with the goal of preventing seizures.
If the patient was standing up they would have fallen down.
The patient’s whole body would go stiff.
The patient might make a crying sound.
The patient will then go to the next phase.
These are clinical manifestations of what phase of a Generalized Tonic-Clonic Seizure?
Tonic Phase
Electrical activity of the brain is recorded by scalp electrodes that are evaluating the electrical activity in the brain
What is the name of this diagnostic test?
EEG / Electroencephalogram
Finish the Nursing Diagnoses related to Seizures?
Ineffective Coping R/T
???
Do not _______ a patient having a seizure. This patient should have padding on their bed. ______ anything on their bed that could hurt them.
Restrain
Remove
Anticonvulsant Drugs generally act by stabilizing nerve cell membranes and preventing abnormal electric impulses from the seizure from spreading from the area of focus to other ____ areas.
Cortical
Study Tip: There are many types of anticonvulsant meds but they are ALL classified as CNS depressants.
What are the 3 most common types of BENZODIAZEPINE anticonvulsant medications that are given to patients with seizures.
Diazepam (Valium) #1 USED FOR SEIZURES
Clonazepam (Klonopin)
Lorazepam (Ativan)
Study Tip: REMEMBER THE –> “PAM”
for BENZODIAZEPINES!
Ex. Pam is dating Benzo !
What 4 reasons does the nurse remain with patient during a seizure?
- The nurse needs to record the START and END time of the seizure.
- The nurse needs to PROTECT the patient from injury because this patient is very vulnerable to injury.
- The nurse must maintain a CALM environment.
- The nurse needs to provide privacy.
When the patient is having a seizure what is the number one priority?
Maintain patent airway is HIGH PRIORITY.
If the patient has status epilepticus you would administer what medication?
Valium
Some people will fake a ______ seizure and one way to know is that they will not lose control of their bladder/bowels.
Generalized tonic-clonic seizure
What is the most common type of BARBITUATE anticonvulsant medication used to treat seizures?
Phenobarbital / Luminal
Study Tip: “BARB” ituates > Pheno “BARB” ital
Finish the Nursing Diagnoses related to Seizures?
Risk for Injury R/T
???
What is the most common type of HYDANTOIN anticonvulsant medication used to treat seizures?
Phenytoin / Dilantin
Study Tip: REMEMBER the > TOIN!
What do you document when administering anticonvulsant medications?
Document characteristics of the seizure:
1. Did the patient go stiff?
Study Tip: Determines whether the patient had Tonic Convulsions
- Did the patient have jerking movements? Study Tip: Determines whether the patient had Clonic Convulsions
- Did the patient lose consciousness?
Study Tip: Determines whether the patient had a Partial or General Seizure - The nurse MUST NOT LABEL the seizure.
Study Tip: The nurse must ONLY document what actually happened. The DIAGNOSIS of the type of seizure can ONLY be made by the Doctor.
Assess:
Assess Respirations
Assess Respiratory Status
Initiate Ventilation or Artificial Respiration if necessary.
These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
What are the 5 OTHER types of anticonvulsant medications?
Carbamazepine / Tegretol Gabapentin / Neurontin Lamotrigine / Lamictal Levetiracetam / Keppra Pregabalin / Lyrica
Generic VS Brand Name Antiepileptic Drugs There was a controversy about whether generic epilepsy drugs are as affective as name brands drugs. The pharmacists will usually sub-brand name with generic and there is some question if there is a link between generic medications and ______ seizure control.
decreased
Study Tip: there is NO evidence of this in the study but the recommendation is to watch any patient at any time there is a CHANGE in their medication [common sense] any patient with any serious medical condition should be MONITORED when there is a change in their meds and the affects.
What causes seizures?
Seizures are caused by the interruption of normal brain functioning by uncontrolled, abnormal, paroxysmal electrical discharge from the neurons within the brain because lack of control by the normal mechanism of control.
Assess: What happens after the seizure: Do the patient get sleepy? Does the patient have a headache? What is their LOC? Is their speech or thinking impaired? Is there an Aura? What happens before the seizure? These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
Study Tip: This patient will get REALLY sleepy after the seizure.
What is the most common type of VALPROATE anticonvulsant medications used to treat seizures?
Valproic Acid / Depakote
Study Tip: “Val”proate > “Val”proic Acid
Identify precipitating factors:
Was the patient playing video games with flashing lights before the seizure?
What was going on before the seizure?
These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
As a nurse we would want to make sure that prior to this procedure that the patient has not had any stimulants.
The nurse must let the patient know that there is no pain during this procedure and that it is non-invasive.
These nursing interventions are required to screen for contraindications to what diagnostic procedure?
EEG / Electroencephalogram
There are many types of anticonvulsants but they are all therapeutically classified as __________.
CNS depressants
The nurse must make privacy a priority.
The nurse must re-orient the patient because they may be confused.
These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
Patient Teaching:
Educate the patient on precautions that people should take when they are diagnosed.
Educate the patient that they are not supposed to drive for a year. Most patients still drive.
These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
The patient has jerking of the limbs.
The patient might have frothing at the mouth. The patient is twitching around.
These are clinical manifestations of what phase of a Generalized Tonic-Clonic Seizure?
Clonic Phase
What type of drug therapy is aimed at preventing seizures?
Anticonvulsant
The nurse should avoid giving the patient or letting the patient drink Alcohol > ETOH this could interfere with their medications.
The nurse must administer medications as directed.
These nursing assessment interventions are implemented during what phase of a Generalized Tonic-Clonic Seizure?
Post-Ictal Phase
Finish the Nursing Diagnoses related to Seizures?
Ineffective Therapeutic Regimen R/T
???
This seizure is which there is a sudden, brief lapse of consciousness, usually for about 2 to 10 sec. The patient resumes activity as if the seizure had not occurred. What type of seizure is this?
Absence Seizure
What three ways can a nurse maintain the AIRWAY of a patient?
- Assess Respiratory Status.
- Reposition the patient to their LEFT side side of the bed so the patient will not swallow their tongue.
- KEEP SUCTION equipment at bedside to maintain the airway.
Contact the Doctor beforehand to determine if the patient has any meds that need to be held before the procedure.
These nursing interventions are required to screen for contraindications to what diagnostic procedure?
EEG / Electroencephalogram
Study Tip: Anti-seizure medications may need to be HELD for a certain amount of time before this procedure so make sure to ask the DOCTOR before you send the patient to the procedure.
The seizure may be induced by voluntary hyperventilation for 2 to 3 min. This type of attack is characteristic of petit mal epilepsy and may recur repeatedly if it is not recognized and treated. This may also progress to a generalized tonic-clonic seizure.
What type of seizure is this?
Absence Seizure
