Seizures Flashcards
What are seizures caused by?
Caused by an electrical disturbance in the nerve cells of the brain
What is a focal seizure?
originates in one hemisphere
Where do generalized seizures occur?
both hemispheres of the brain
What are provoked seizures related to?
an acute, reversible condition
Examples of conditions that cause provoked seizures (3)
- infection
- immune response
- metabolic condition
Examples of diseases that cause seizures (10)
Cerebrovascular disease (stroke, brain hemorrhage) Hypoxemia Fever (childhood) Head injury Hypertension Central nervous system infections Metabolic and toxic conditions Brain tumor Drug and alcohol withdrawal Allergies
Definition of epilepsy
at least 2 unprovoked seizures more than 24 hours apart
cause of primary epilepsy
idiopathic
cause of secondary epilepsy (8)
- stroke
- brain tumor
- head injury
- meningitis
- infectious disease
- toxicity
- fever
- drugs / alcohol
Clinical manifestations of epilepsy (9)
- staring episode
- convulsions
- loss of consciousness
- epileptic cry
- twitching
- unintelligible speech
- tonic-clonic contractions (alternating relaxation and contraction states)
- incontinence
- patient may experience unusual sights, sounds, odors, or taste
What is the postictal phase?
period immediately following a seizure
How may the patient be during the postictal phase? (2)
- confused
- sleepy and hard to arouse
What may be the patient complain of in the postictal phase? (4)
- HA
- fatigue
- muscle soreness
- depression
assess and determine what in relation to seizures (2)
- determine seizure type, severity and frequency
- assess pt’s hx to determine cause of seizure
Seizure diagnostic tests (3)
MRI –> may show any abnormalities
CBC/chemistry panels –> hyponatremia, Bleeding (H/H, platelets)
EEG
Tegretol side effects (4)
dizziness, N/V, severe skin rash, hepatitis
Keppra side effects (3)
somnolence, dizziness, fatigue
Dilantin side effects (4)
visual problems, gum hyperplasia, dysrhythmias, severe skin reactions
Complications of Vagal Nerve Stimulator (4)
- Infection
- cardiac dysrhythmias
- hoarseness
- cough
Seizure precautions (7)
- oxygen and suction available
- privacy provided as soon as possible
- side rails up and padded
- bed in lowest position
- pillow under head
- patient in side-lying position
- loosened clothing
What is the major responsibility of the nurse in regards to seizures?
Observe and record the sequence and signs of the seizure
Seizure management before it happens (2)
- assess for presence of stimuli (sensory, emotional, sleep deprivation)
- occurrence of an aura
Nursing management during a seizure —> 5
- look for the first thing the patient does during a seizure
- ease patient to floor (if not lying down)
- observe where initial movement or stiffness of body begins
- observe and record events of seizure/characteristics
- provide a safe environment
Nursing management after seizure —> 5
- Assess pt’s ability to speak
- assess patient’s cognitive status
- Did pt lose consciousness?
- side-lying position (facilitates drainage of oral secretions)
- assess if pt remembers the seizure
Nursing interventions for seizure (8)
- nurse observes and records s/s of pt’s seizure
- maintain patent airway, suction if necessary
- provide safe environment for patient to prevent injury
- monitor vital signs
- provide O2
- reorient after seizure
- educate on importance of maintaining anticonvulsant therapy
- do not restrain patient or insert anything in the mouth
Potential complications of seizure disorders —> 2
- status epilepticus
- medication toxicity
What can cause status epilepticus?
- interruption of anticonvulsant medication
- fever
- infection
Nursing interventions for status epilepticus (5)
- administer IV anticonvulsants
- maintain airway
- prevent injury to patient
- place in side lying position
- suction as needed
What is status epilepticus?
-a series of generalized seizures that occur without full recovery of consciousness between attacks or continuous clinical or electrical seizures (on EEG) lasting at least 30 min
