Seizure Disorder - 405

Question 1

seizures disorders (epilepsy)

Answer 1

transient, uncontrolled electrical discharge of neurons in brain that interrupts normal function
if the seizures stop when the underlying problem is correct, it is not referred to as a seizure “disorder”

Question 2

generalized seizures happen where

Answer 2

on both sides of brain

Question 3

tonic

Answer 3

stiffen for 10-20 secs

Question 4

clonic

Answer 4

jerking 30-40 secs

Question 5

tonic clonic seizures

Answer 5

-loses consciousness, falls to ground
-salivation, diaphoresis, tongue biting and incontinence
-post ictal may sleep for hours (let them sleep)
-no memory of experience

Question 6

absence seizure

Answer 6

-rarely beyond adolescence
-brief staring spell that resembles daydreaming; last less than 10 secs, unresponsive when spoken to during seizure

Question 7

focal onset seizures happen where

Answer 7

one hemisphere of brain

Question 8

focal onset seizure: w/ retained awareness

Answer 8

-no loss of consciousness
-lasts less than 1 min
-have unusual sensations that can take on many forms: joy, anger, sadness, nausea
-may hear, smell, taste, or see things that are not real

Question 9

focal onset seizure: w/o retained awareness

Answer 9

-eyes open, but have loss of consciousness or change in awareness (feel like dreaming)
-make movements that seem purposeful but cannot interact w/ observer
-walk into traffic; take off clothes; ect
-1 to 2 mins, tired & confused afterward

Question 10

4 phases of a seizure: prodromal

Answer 10

sensations or behavior changes that precede a seizure by hours to days

Question 11

4 phases of a seizure: aural

Answer 11

sensory warning that a seizure is about to happen

Question 12

4 phases of a seizure: ictal

Answer 12

first symptom through the end of seizure activity

Question 13

4 phases of a seizure: post ictal

Answer 13

recovery period after the seizure

Question 14

dx for seizure

Answer 14

-accurate/comprehensive description of seizure activity
-pt health hx
-EEG w/n 24 hrss of seizures
-labs to rule out other metabolic disorders

Question 15

first aid during a seizure

Answer 15

1) assure patent airway / suction & supplement O2 prn
-padded bed rails
-no forcing objects into mouth
-do not restrain movements
-stay w/ person until seizure ends
-turn head if possible and not forced

Question 16

what to monitor during a seizure

Answer 16

-VS, LOC, SpO2, GCS, pupil size & reactivity
-time of onset & duration
-accurate documentation

Question 17

cyanosis seen in tonic clonic seizures is usually

Answer 17

self limiting

Question 18

when is a seizure a medical emergency

Answer 18

when it lasts >5 mins or has one back to back

Question 19

status epilepticus

Answer 19

-a prolonged seizure or repeated seizures over course of 30 mins
-rapid response team -> ICU
-airway is #1
-IV lorazepam or diazepam is drug of choice
-seizure >10mins can cause death

Question 20

what does a person need if they are at risk for seizures in the hospital

Answer 20

IV access

Question 21

antiepileptic drugs mgt

Answer 21

-start with one drug & titrate & then add another if needed
-older drugs have a narrow therapeutic index
-do not abruptly withdraw, adherence is very important

Question 22

what is a classic side effect of phenytoin

Answer 22

gingival hyperplasia

Question 23

surgical mgt of seizures

Answer 23

-surgical resection of affected area
-vagal nerve stimulation (pacemaker of the brain)

Question 24

what is the most common complication of living w/ seizures

Answer 24

psychosocial ramifications