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AH 1 > Test 3 Seizures vs. Epilepsy (CNS, Brain) > Flashcards

Test 3 Seizures vs. Epilepsy (CNS, Brain) Flashcards

1
Q

_____ are abrupt, abnormal, excessive and uncontrolled electical discharge of neurons within the brain that may cause alterations in the level of consciousness and/or changes in motor and sensory ability and/or behavior.

A

Seizures

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2
Q

_____ is the term used to define a syndrome characterized by chronic recurring abnormal brain electrical activity.

A

Epilepsy

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3
Q 
Seizure:
\_\_\_\_\_\_\_
\_\_\_\_\_\_\_
\_\_\_\_\_\_\_
\_\_\_\_\_\_\_ \_\_\_\_\_\_

Epilepsy:
_____ or ______
Seizures on ____ ____ (___-term)

A

Seizure:

  • Generalized
  • Partial
  • Unclassified
  • Secondary seizures

Epilepsy:

  • Primary or idiopathic
  • Seizures on regular basis (long-term)
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4
Q

Which type of Generalized seizure?

Both cerebral hemispheres
2 -5 minutes
Loss of consciousness
Incontinent
Biting of tongue
Postictal period with fatigue, lethargy, confusion
A

Tonic-clonic

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5
Q

Which type of Generalized seizure?

Abrupt increase in muscle tone
Loss of consciousness (LOC)

Lasts 30 seconds to several minutes
A loss of consciousness occurs

A

Tonic seizure

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6
Q

Which type of Generalized seizure?

Muscle contraction and relaxation.

Lasts several minutes

A

Clonic seizure

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7
Q

Which type of Generalized seizure?

  • Most common in children
  • Loss of consciousness lasting a few seconds
  • Associated with blank stare
  • May also include unconscious, involuntary behavior associated with eye fluttering, smacking lips, and picking at clothes called automatism.
A

Absence seizures

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8
Q

Which type of Generalized seizure?

Brief jerking or stiffening of extremities
(may symmetrical or asymmetrical)

Lasts for seconds

A

Myoclonic seizure

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9
Q

Which type of Generalized seizure?

-Sudden loss of muscle tone

  • Followed by period of confusion
  • Loss of muscle tone frequently results in falling
A

Atonic (or akinetic) seizure

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10
Q

What are the 2 types of partial or focal/local seizures?

A

Complex partial seizure

Simple partial seizure

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11
Q

Partial or focal/local seizure:

What are characteristics of complex partial seizures?

\_\_\_ \_\_\_ \_\_\_\_ (\_\_\_\_ minutes)
\_\_\_\_ can occur
\_\_\_\_\_\_ post seizure
 Also called \_\_\_\_ or \_\_\_ \_\_\_\_ seizures
More common in \_\_\_\_ \_\_\_\_\_
A

Complex partial:

  • LOC (Loss of consciousness) 1-3 minutes
  • Automatisms can occur
  • Amnesia post seizure
  • Also called psychomotor or temporal lobe seizures
  • More common in older adults
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12
Q

Partial or focal/local seizure:

What are characteristics of Simple partial seizures?

_____ _____
____ may occur
___ ____ movement
____ ____ (May know when it is coming on)

Can have ____ ____ such as changes in heart rate and abnormal flushing, unilateral abnormal extremity movements, pain or offensive smell.

A

Simple partial:

  • Remains conscious
  • Aura may occur
  • One sided movement
  • Unusual sensations (May know when it is coming on)
  • Can have autonomic symptoms
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13
Q

What are the seizure risk factors?

A 
Metabolic disorders
Acute alcohol withdrawal
Electrolyte disturbances
Heart disease
High fever
Stroke
Substance abuse
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14
Q

What are the seizure precautions?

A

Seizure Precautions:

Oxygen 
Suction equipment
Airway 
IV access
Side rails up
No tongue blades
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15
Q

How do you take care of a patient during a seizure (patient safety)?

A
  • *Depends on the type of seizure
  • Protect the patients privacy and keep away from injury (remove furniture and hold head in lap if on floor)
  • Do not force anything in mouth
  • Side-lying position to keep airway clear
  • Loosen restrictive clothing
  • Do not attempt to restrain patient!!!
  • Record when seizure began, ended, and observations.
  • Call for help! (Especially, if airway conpromised)
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16
Q

What is a prolonged seizure that lasts more than 5 minutes or repeated seizures over course of 30 minutes — Medical emergency?

A

Status epilepticus

17
Q

What causes Status epilepticus?

A

Causes:

  • Withdrawal from drugs or alcohol
  • Sudden withdrawal from antiepileptic -medications
  • Head injury
  • Cerebral edema
  • Infection
  • Fever
18
Q

What is the nursing action for status epilepticus?

A

Status epilepticus (Nursing Action):

  • Establish and maintain airway
  • Provide oxygen
  • Establish IV access
  • IV push lorazepam, diazepam
  • Rectal diazepam
  • Loading dose of IV phenytoin
  • ABGs
19
Q

What is the Acute seizure management ?

A

Acute Seizure Management:

  • Lorazepam (Ativan) –> Most commonly given IV for active seizures
  • Diazepam (Valium) - Not first b/c has lots of side effects.
  • Diastat
  • IV phenytoin (Dilantin) or fosphenytoin (Cerebyx):
20
Q

What are the nursing considerations for the drug therapy?

A

Drug Therapy Nursing Considerations:

  • Therapeutic levels determined by blood tests
  • Drug-drug/drug-food interactions
  • Maintain therapeutic blood levels for maximal effectiveness
  • Do not administer warfarin with phenytoin!!!
  • Document and report side/adverse effects
  • Medications should be taken same time everyday.
21
Q

What medications should not be taken with phenytoin and why?

A
  • Do not administer warfarin with phenytoin because phenytoin may decrease absorption and increase metabolis or oral anticoagulants.
  • Oral contraceptive b/c phenytoin decreases their effectiveness
22
Q

What are the surgical managements?

A

Surgical interventions include placement of a vagal nerve stimulator and excision of the portion of the brain causing the seizures for intractable seizures (anterior temporal labe resection or partial corpus callosotomy).

23
Q

Surgical management:

What surgical intervention is used to treat refractory complex partial seizures?

A

Anterior temporal lobe resection

24
Q

What surgical intervention interrupts the communication between the 2 cerebral hemispheres?

A

Partial corpus callosotomy

25
Q

How does the vagal nerve stimulator work? (patient teaching)

Where is the vagal nerve stimulator?

A

Instruct patient to initial vagal nerve stimulation by holding a magnet over the implanted device, at the onset of seizure activity.
-This will abort the seizure or lessen severity.

-The VNS is implanted in the left chest wall and connected to an electrode placed in the left vagus nerve.
(Done under general anesthesia)

AH 1 (16 decks)

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