Neuro

Question 1

Epilepsy nursing assessment

Answer 1

Health History; Physical Examination

Laboratory and Diagnostic Tests: LP, CT, MRI, EEG

Question 2

Epilepsy patho

Answer 2

Disruption of electrical communication among the neurons of the brain
Neurons either fire when they are not supposed to or not fire when they should

Question 3

Partial seizure

Answer 3

one area of the brain is involved

simple or complex

Question 4

Generalized seizure

Answer 4

entire brain involved

infantile spasms, absence sz, tonic-clonic sz, myoclonic sz, atonic sz

Question 5

Epilepsy therapeutic management

Answer 5

Goal is to control sz or reduce frequency
Anticonvulsants
Surgery (uncontrolled)
Ketogenic diet: high fat low carb
Vagal nerve stimulator

Question 6

Epilepsy: labs and diagnostic

Answer 6

Serum glucose , electrolytes, calcium (r/o metabolic caused)
Lumbar puncture (r/o meningitis or encephalitis)
Skull x-ray (evaluate presence of fracture or trauma)
CT and MRI (identify abnormalities and intracranial bleeds, r/o tumors)
EEGs (may be + with certain sz, normal EEG does not r/o epilepsy; can be usual in evaluate
Video EEG (view actual behavior on video, “catch” sz)

Question 7

Epilepsy: seizure precautions

Answer 7

Padding of side rail and other hard objects
Side rails raised on bed at all times
Oxygen and suction at bedside
Supervision, especially during bathing, ambulation, or other potentially hazardous activities
Use of a protective helmet during activities may be appropriate
Child should wear a medical alert bracelet

Question 8

Febrile seizure

Answer 8

Most common type of sz in children younger than 5
Peak incidence b/t 18 and 24 months
Increased risk with family history
Usually benign with excellent prognosis

Question 9

Therapeutic management of febrile seizure

Answer 9

Determine cause of fever and control fever

Rectal diazepam in high risk or anxious parents

Question 10

Febrile seizure nursing assessment

Answer 10

Core temp increased rapidly, above 102.2
Generalized tonic-clonic last seconds to 10 minutes followed by brief postictal period
simple febrile sz is a generalized sz lasting less than 15 minutes in a 24 hr period, and fever
Risk factors for recurrence- age at 1st febrile sz, family history and high fever

Question 11

Neonatal seizures

Answer 11

Immature brain is more prone to sz activity
Sz that occur within the 1st 4 weeks of life, usually within the 1st 10 days
Associated with underlying condition (hypoxic-ischemic encephalopathy, hypoglycemia, infection, intracranial hemorrhage)
Prognosis depends on cause and severity

Question 12

Neonatal seizure therapeutic management

Answer 12

Aggressive therapy
Adequate ventilation
Correct underlying problem
Administering anticonvulsants (Phenobarbital often used initially)
Dosing higher in neonates b/c neonates metabolize drugs more rapidly than older infants

Question 13

Neonatal seizure nursing assessment

Answer 13

Tremors and jitteriness common, autonomic changes (tachycaridia, elevated BP), ocular deviation

Question 14

Neonatal seizures nursing management

Answer 14

Control seizure
Neurologic status monitoring
Injury prevention
Support and education

Question 15

Distinguising neonatal seiuzures from nonepileptic movements

Answer 15

seizure- tahcycardia and increased bp
movement not suppressed by general restraint
seizure acitivity unchanged by sensory stimuli

Nonepileptic moments- no changes in VS