Module 8 Part 3: Seizure Disorders

Question 1

what is the definition of a seizure?

Answer 1

episodes of abnormal motor, sensory, autonomic, or psychiatric activity

Question 2

what are seizures a result of?

Answer 2

sudden excessive discharge from the cerebral neurons

Question 3

what are partial seizures?

Answer 3

begin in one part of the brain

Question 4

what are generalized seizures?

Answer 4

involve electrical charges in the whole brain

Question 5

is consciousness lost in a simple partial seizure?

Answer 5

NO

Question 6

is consciousness lost in complex partial seizures?

Answer 6

YES

Question 7

are seizures idiopathic or acquired?

Answer 7

can be both!

Question 8

what are some things that can cause seizures?

Answer 8

• cerebrovascular disease
• hypoxemia
• fever (childhood)
• head injury
• hypertension
• CNS infections
• metabolic and toxic conditions
• brain tumor
• drug and alcohol withdrawal
• allergies

Question 9

what is important to do for the patient during the seizure?

Answer 9

• protect the patient from injury

- observe and record

Question 10

what does the nature of the seizure determine?

Answer 10

the type of treatment is required

Question 11

what things are you looking for when assessing a patient before or during a seizure? (ITS LOOOONG)

Answer 11

• circumstances of the seizure
• the occurrence of an aura
• the first thing the patient does in the seizure;
• the type of movement involved
• the area of the body involved
• the size of pupils and whether the eyes are opened
• whether the eyes or head is turned to one side
• incontinence of urine or stool
• duration of the seizure
• inability to speak after
• movements at the end

Question 12

what do you have to monitor about the first thing a patient does in a seizure?

Answer 12

• where the movements and stiffness begin

- conjugate gaze position, and the position of the head at the beginning of the seizure

Question 13

why do we care about the position at the beginning of the seizure?

Answer 13

because it gives indication where the seizure begins in the brain

Question 14

what does the nurse need to do after the seizure?

Answer 14

document the events leading up to and occurring during and after the seizure to prevent complications

Question 15

what is the patient at risk for after the seizure?

Answer 15

• hypoxia
• vomiting
• pulmonary aspiration

Question 16

why is the patient placed in side-laying position while the seizure is happening?

Answer 16

• to drain the secretions out of their mouth and to reduce the risk of aspiration
• use suction if needed

Question 17

what do you do to the patient’s bed to prevent injury?

Answer 17

the lowest position, 2-3 rails up and padded

Question 18

what is epilepsy?

Answer 18

a group of syndromes characterized by unprovoked, recurring seizures

Question 19

what are epileptic syndromes classified by?

Answer 19

• age of onset
• family history
• seizure type

Question 20

what do the different types of seizures differ?

Answer 20

how the seizure activity manifests

Question 21

when is epilepsy primary?

Answer 21

when they are idiopathic

Question 22

when is epilepsy considered secondary?

Answer 22

when the cause is known and epilepsy is a symptom of another disease such as a brain tumor

Question 23

what produces the “epileptic cry”?

Answer 23

simultaneous contractions of the diaphragm and chest muscles

Question 24

what is a diagnostic assessment for?

Answer 24

• determining the type of seizure, their frequency and severity, and the factors that precipitate them

Question 25

what is an MRI used for in epilepsy?

Answer 25

used to detect clinical lesions such as focal abnormalities, cerebrovascular abnormalities, and cerebral degenerative changes

Question 26

what is an ECG used for in epilepsy?

Answer 26

evidence for substantial proportions of patients with epilepsy and assists in clarifying the type of seizure

Question 27

what are microelectrodes?

Answer 27

can be inserted deep in the brain to probe the action of a single brain cell

Question 28

what is telemetry used for in seizure disorders?

Answer 28

used to monitor electrical activity in the brain activity while the patient pursues his or her usual activity

Question 29

what is a special consideration for women?

Answer 29

seizure activity is increased during menses because the sex hormones alter the excitability of the neurons in the brain

Question 30

what medications effects are decreased when taking antiseizure medications?

Answer 30

contraceptives

Question 31

what happens during pregnancy in women with seizure disorders?

Answer 31

change in pattern in seizures

Question 32

how much greater is congenital fetal anomalies when the mother has epilepsy?

Answer 32

2-3X higher

Question 33

what is the leading cause of seizures in older adults?

Answer 33

cerebrovascular disease

Question 34

how effective are medications taken by patients with seizures?

Answer 34

control seizures in 70-80% of patients with seizures

Question 35

what are 3 reactions that can happen with antiseizure medications?

Answer 35

1) idiosyncratic or allergic disorders
2) acute toxicity
3) chronic toxicity

Question 36

under what conditions is surgery a treatment for those with seizure disorder?

Answer 36

• intracranial tumours
• abscesses
• cysts
• vascular abnormalities

Question 37

what are the potential complications of people with epilepsy?

Answer 37

• status epilepticus

- medication side effects (toxicity)

Question 38

what is status epileptics?

Answer 38

• acute prolonged seizure activity

- a series of generalized seizures that occur without full recovery of consciousness between attacks

Question 39

what do you do if the patient remains unconscious and unresponsive during status epilepticus?

Answer 39

• endotracheal tube
• IV valium
• ativan
• cerebryx
  (administered slowly to try to halt seizures)