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Critical Care Nursing Exam 3 > Seizures > Flashcards

Seizures Flashcards

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1
Q

what are seizures?

A

abnormal episodes of motor, sensory, autonomic or psychic activity

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2
Q

what do seizures look like on an EEG?

A

abnormal uncontrolled electrical discharge from cerebral neurons

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3
Q

what are the different classifications of seizures?

A
  • partial
  • simple partial
  • complex partial
  • generalized
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4
Q

what is a partial seizure?

A

focused in one part of the brain

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5
Q

what is a generalized seizure ?

A

affects the whole brain

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6
Q

what is epilepsy?

A

condition characterized by recurrent seizures

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7
Q

what are some causes of secondary seizures?

A
  • brain tumor
  • ETOH
  • electrolyte imbalance (Na+, Mag, BG)
  • metabolic dysfunction
  • drugs
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8
Q

what medication is contraindicated for people with epilepsy?

A

flumazenil

it is the antidote for bentos and stimulates the development of seizures

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9
Q

triggering factors for seizures?

A
  • loud music
  • flashing lights
  • specific odors
  • med dose changes
  • forgot to take a med
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10
Q

what is the most common trigger for epilepsy?

A

med withdrawal, forgot to take their medication

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11
Q

what medications likely to cause epilepsy with withdrawal?

A

antidopaminergics - quetiapine, aripiprazole, haloperidol
atypical antipsychotics- clozapine
antidepressants- bupropion
antibiotics-cyclosporine, quinolone

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12
Q

what are some anti-dopaminergics?

A

aripiprazole, haloperidol

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13
Q

what are some atypical antipsychotics?

A

clozapine, risperidone, quetiapine

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14
Q

what are some antidepressants?

A

sertraline, buproprion

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15
Q

what is an absence seizure?

A

a seizure that looks like someone is zoned out?

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16
Q

what population is absence seizures most common in?

A

children

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17
Q

nursing considerations for prepping for an EEG?

A

C-clean hair (no lotions or conditioners)
E-education (educate patient and family)
C- confirm (confirm medications and diet orders)
A-assist (assist the tech or physician with positioning)

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18
Q

do nurses place stickers for an EEG?

A

no

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19
Q

what type of substances may need to be held for 24 hours prior to an EEG?

A

sedatives, stimulants, anticonvulsants, tea, coffee

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20
Q

what is a simple partial seizure also known as?

A

focal aware seizure

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21
Q

do patients with simple partial seizures experience an aura?

A

yes, often a smell, colors, or a vision

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22
Q

do patients with a simple partial seizure go unconscious?

A

no they have no impairment of consciousness

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23
Q

what type of seizure is a Jacksonian march seizure?

A

a simple partial

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24
Q

what does a Jacksonian march seizure look like?

A

focal seizures with unilateral clonic movements that start in one group of muscles and spread to adjacent groups

one sided clonic movements that move adjacently to the other side

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25
Q

what is a complex partial seizure also known as?

A

focal unaware

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26
Q

do patients having a complex seizure lose consciousness?

A

yessss

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27
Q

what are the 4 types of generalized seizures?

A

absence
tonic
clonic
tonic- clonic

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28
Q

what is an absence seizure?

A

brief, sudden lapses of consciousness, spaced out

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29
Q

do absence seizures cause convulsions?

A

no, just spacing out

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30
Q

what is a tonic seizure?

A

the body, arms, or legs may be suddenly stiff or tense

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31
Q

what is a clonic seizure?

A

jerking of body, or parts of the body

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32
Q

what is a tonic clonic seizure?

A

alternates stiffness with jerking
can be unilateral or bilateral
occurring at any age
loss of bladder control

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33
Q

what are tonic clonic seizures also known as?

A

grande mal

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34
Q

what does the postictal phase look like?

A

sleepy, confused, aggressive

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35
Q

how long is the postictal state?

A

30min-2hrs

can last 24-72 hrs

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36
Q

what happens in the postictal phase?

A

dysphasia, slurred speech, confusion, amnesia

37
Q

what do we document ?

A

time of onset, how long it lasts, what happens before (aura), what happens during (movements, incontinence, 02 sat, vomiting)

38
Q

what are protocols for seizures?

A

EEG, ABC’s, BG, IV access, labs, suction set up, AED

39
Q

what drugs can you expect with a patient having seizures?

A

Ativan, keppra

40
Q

what are seizure precautions?

A

padded bedrails, no restraints, suction, turn on side, remove triggers, bed in lowest position, loose clothing, suction and oxygen set up

41
Q

what are the 3 categories of anticonvulsants?

A

benzodiazepines
hydantoins
barbiturates

42
Q

what is the most common med used to stop seizures, and what type of drug is it?

A

Ativan (lorazepam) and is a benzodiazepine

43
Q

what are the hydantoins we use for seizures?

A

dilantin, cerebyx

44
Q

what type of drug Is phenobarbital?

A

barbiturate

45
Q

what is the danger with cerebyx?

A

can effect ventricular automaticity

46
Q

what can cerebyx cause?

A

PVC’s, vtach

47
Q

what patients can we not give cerebyx too?

A

patients with a history of heart blocks

48
Q

what type of dose would we give phenobarbital as for use as an anticonvulsant?

A

high dose to get anticonvulsant properties

49
Q

what type of medication is clonazepam?

A

anti-epileptic

50
Q

what type of medication is phenytoin?

A

anticonvulsant

51
Q

what type of medication is phenobarbital?

A

barbituate or anticonvulsant

52
Q

what type of medication is lamotrigine?

A

anti epileptic, used to treat epilepsy

53
Q

what type of medication is primidone?

A

anticonvulsant

54
Q

what type of medication is valproic acid?

A

anticonvulsant

55
Q

what type of medication is carbamazepine?

A

anticonvulsant

56
Q

what complication can dilantin cause?

A

gingival hyperplasia

57
Q

why does dilantin cause gingival hyperplasia?

A

causes an increase in calcium and a decrease in folic acid, as well as a decrease in platelets and WBCs causing gingival hyperplasia

58
Q

what type of drugs are used for status epilepticus?

A

benzodiazepines

59
Q

what can barbiturates cause?

A

respiratory depression

60
Q

what type of seizures are barbiturates used for?

A

tonic-clonic and acute seizures

61
Q

what is the antidote for barbiturates?

A

there is not an antidote for barbs

62
Q

what are benzos used for?

A

status epileptics and absence seizures

63
Q

what is the antidote for bentos?

A

flumazenil

64
Q

what are valproates?

A

depakote, used for generalized, focal and absence seizures

65
Q

what can valproic acid cause?

A

blood clotting and liver toxicity

66
Q

what labs might you look at when a patient is taking depakote?

A

AST, ALT, Platelets, coagulation panel

67
Q

what type of drug is topiramate?

A

antiepileptic

68
Q

what type of drug is clobazam?

A

an anticonvulsant treating seizures caused by Lennox-gaustaut syndrome

69
Q

what type of drug is oxcarbazepine?

A

anticonvulsant

70
Q

what type of drug is ethosuximide?

A

anticonvulsant

71
Q

what type of drug is vigabatrin?

A

anticonvulsant

72
Q

what type of drug is gabapentin?

A

used for nerve pain and anticonvulsant and pain for seizures

73
Q

what type of drug is levetiracetam?

A

anticonvulsant

74
Q

why is the keto diet effective in epilepsy?

A

epilepsy is believed to be a metabolic condition and changes in the blood, CSF, and ketosis from the keto diet can decrease the excitability of neurons and help to stabilize seizures.

75
Q

what is the risk of the keto diet?

A

higher risk of kidney stones, bone fractures and constipation

76
Q

what are some interventions related to seizures?

A

monitor drug levels and watch for toxicity

monitor for drug interactions

77
Q

what meds can make epileptic drugs ineffective?

A

Birth control, immunosuppressants, antibx, antipsychotics

78
Q

what is status epilepticus?

A

continuous series of seizures

79
Q

what is the result of status epilepticus?

A
  • metabolic demands
  • cerebral hypoxia
  • respiratory arrest
  • concern for cerebral perfusion
80
Q

treatment for status epilepticus?

A

diazepam
lorazepam
fosphenytoin

81
Q

how long does it take for neuronal damage to occur?

A

20-60mins

82
Q

what does status epilepticus cause?

A

postictal cerebral edema

83
Q

what does postictal cerebral edema cause?

A

increased ICP, decreased cerebral perfusion

84
Q

what s/s would you see with postictal cerebral edema?

A

HA, dizziness, nausea, numbness, poor coordination, weakness

85
Q

what severe s/s may you see with postictal cerebral edema?

A

dysphasia, memory loss, incontinence, altered LOC, seizures

86
Q

what does postictal cerebral edema put people at risk for?

A

it puts them at high risk of more seizures due to increased ICP

87
Q

what is the tx for postictal cerebral edema?

A

medications, fluids, hypothermia, ventriculostomy

88
Q

what type of meds may you see with postictal cerebral edema?

A

mannitol

3% NS

Critical Care Nursing Exam 3 (5 decks)

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