seizures and epilepsy Flashcards
1
Q
seizures
A
abrupt, abnormal, excessive, and uncontrolled electrical discharge of neurons within the brain
2
Q
what alterations does seizures cause
A
cause alterations in the level of consciousness and/or changes in motor and sensory ability and/or behavior
3
Q
epilepsy
A
chronic recurring abnormal brain electrical activity resulting in two or more seizures.
4
Q
how to know its a true seziure
A
extremity keeps convulsing when held down, 02 drops, loose control of bowl
5
Q
what to do during seziure
A
- prioritize airway, bring to floor, move everything away, lay on left side, nothing in mouth, observe, call for help, describes types of movement, length, how they acted afterwards
6
Q
risk factors:
A
- Genetic predisposition: Absence seizures are more common in children and tend to occur in families.
- Acute febrile state: Particularly among infants and children younger than 2 years old.
- Head trauma: Can be early or late onset (up to 9 months), and incidence is increased when the head trauma includes a skull fracture.
- Cerebral edema: Especially when it occurs acutely and seizure activity tends to disappear when the edema is successfully treated.
- Abrupt cessation of antiepileptic drugs (AEDs):
- Infection
- Metabolic disorder
- Exposure to toxins: Especially those associated with pesticides, carbon monoxide, and lead poisoning.
- Stroke: Most likely to occur within the first 24 hr following a stroke as a result of increased intracranial pressure.
- Heart disease: Common cause of new-onset seizures in older adults.
- Brain tumor
- Hypoxia: Results in a decreased oxygen level of the brain; necessary for neuronal activity.
- Acute substance withdrawal
- Fluid and electrolyte imbalances
7
Q
triggering factors
A
- Increased physical activity
- Excessive stress
- Hyperventilation
- Overwhelming fatigue
- Acute alcohol ingestion
- Excessive caffeine intake
- Exposure to flashing lights
- Substances such as cocaine, aerosols, and inhaled glue products
- sodium activity
8
Q
types of seizures
A
Partial or focal/local seizure
Complex partial seizure
Simple partial seizure
Unclassified or idiopathic seizures
9
Q
Diagnostic Studies For Seizures
A
- Electroencephalogram (EEG) records electrical activity and can identify the origin of seizure activity.
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
- Positron emission tomography (PET) scan
- Cerebrospinal fluid (CSF) analysis
- Skull x-ray can be used to identify or rule out potential causes of seizures
10
Q
nursing care during a seziure
A
- Protect the client’s privacy and the client from injury (move furniture away, hold head in lap if on the floor).
- Position the client to provide a patent airway.
- Be prepared to suction oral secretions.
- Turn the client to the side to decrease the risk of aspiration.
- Loosen restrictive clothing.
- Do not attempt to restrain the client.
- Do not attempt to open the jaw or insert airway during seizure activity (can damage teeth, lips, and tongue).
- Do not use padded tongue blades.
- Document onset and duration of seizure and findings (level of consciousness, apnea, cyanosis, motor activity, incontinence) prior to, during, and following the seizure.
11
Q
nursing care after a seizure
A
- This is the postictal phase of the seizure episode.
- Maintain the client in a side-lying position to prevent aspiration and to facilitate drainage of oral secretions.
- Check vital signs.
- Assess for injuries.
- Perform neurological checks.
- Allow the client to rest if necessary.
- Reorient and calm the client, who might be agitated or confused.
- Determine if client experienced an aura, which can indicate the origin of seizure in the brain.
- Try to determine possible trigger (e.g., fatigue).
12
Q
seizure meds
A
- Phenytoin (Dilantin)
- Carbamazepine (Tegretol)
- Valproic acid ( Depakene, Depakote)
- Phenobarbital (Luminal)
- Levetiracetam (Keppra): long term use
- Topiramate (Topamax)
13
Q
med info
A
- Administer prescribed antiepileptic drugs (AEDs), such as phenytoin.
- Initial goal is to control seizure activity using one medication.
- If the chosen medication is not effective, either the dose is increased, or another medication is added or substituted.
- Therapeutic levels are determined by blood tests.
- The client should take medications at the same time every day to enhance effectiveness.
14
Q
meds adverse effect
A
- Be aware of adverse effects and interactions with food or other medications.
These are specific to the medication. - Some antiepileptic medications cause oral gum overgrowth.
Routine oral hygiene and dental visits can minimize this adverse effect.
15
Q
phenytoin special instructions
A
avoidance of oral contraceptives, as this medication decreases their effectiveness.
and dilantin
