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Seizures Review
Nursing Implications for Seizures
| Question | Answer |
|---|---|
| Seizures are... | Seizures are abrupt uncontrolled electrical brain discharges that cause alterations in level of consciousness and change in motor and sensory behavior |
| Seizures can lead to... | Hypoxia, cardiac dysrhythmias and lactic acid |
| epilepsy differs from seizures BC | It is a characterized by RECURRING seizures |
| What causes epilepsy | Epilepsy can be idiopathic (Cause not known) or secondary to brain tumors, acute alcoholic withdrawal and or electrolyte imbalance |
| Status epilepticus is | series of generalized seizures with no recovery in btwn lasting >30 minutes |
| For Status Epilepticus what drugs can be given? | PRESCRIBED, valium, ativan or continuous infusion of phenytoin (dilantin) |
| What are factos that can trigger seizures? | increased physical activity, stress, fatigue, alcohol, caffeine, some chemicals |
| Seizures are classified as | partial/focal or generalized |
| Partial seizures can be further divided into three subgroups | simple partial seizures, simple focal seizures and partial seizures with complex symptomatology (also called psychomotor or temporal lobe) |
| Simple Focal seizures | Resulting from an abnormal localized cortical discharge |
| Partial seizures with complex symptomatology | also called psychomotor or temporal lobe seizures and usually originate in the temporal lobe of the brain |
| complex partial seizures | consciousness is partially or completely impaired. Pts usually experience an aura (warning sign of seizure) Also the person experiencing the seizure has no memory of the events during the seizure |
| generalized seizures | characterized by bilateral synchronous electrical discharges in the brain. Involvement in both hempispheres,most commonly impairment of consciousness with bilateral motor involvement NO AURA (warning) |
| Tonic-Clinic | Also Called Grand Mal |
| Tonic Stage | May have aura, stiffening/rigidity 10-20 seconds |
| Clonic stage | Hyperventilation, Rhythmic jerking 30-40 seconds, Loss of Consciousness, May become incontinent. |
| Absence seizures | Also called Petit Mal, little or no change in muscle tone, may occur >100x/day |
| Atonic/Akinetic =Drop Attacks | Sudden momentary loss of muscle tone, may incur injuries from fall |
| Anticonvulsants medication should be used with CAUTION in patients taking | anticoagulants, aspirin, sulfonamides, cimetidine (tagamet), antipsychotic drugs, antacids, sulfonamides |
| what is the therapeutic Serum ranges for Tegretol and Dilantin? | tegretol = 3-14 mcg/ml Dilantin = 10-30mcg/ml |
| Dilantin/Phentoin | Used to tx PARTIAL AND GENERALIZED TONIC/CLINIC seizures, decreases effects of birth control pills, teratogenic effects if taken during pregnancy. SE causes Gingivitis |
| Luminal/Phenobarbital | Used to treat tonic/clonic seizures and acute episodes of seizures caused by status epilepticus MAY be used with anesthesia |
| Valium and Ativan | used to treat absence seizures |
| Valium can also treat | status epilepticus, anxiety and skeletal muscle spasm |
| Depakote | used to treat tonic clonic, partial and myoclonic and psychomotor seizures |
| Tegretol | Limits nerve impulse by limiting sodium ions across membrane, GIVE with meals, SE - Diplopia, leukopenia Contraindicated with liver disease |
| Nursing interventions that are appropriate during a seizure | Provide privacy, ease the pt, if standing, to the floor, make the the environment safe, Loosen the pts clothing. |
| For Dilantin (phenytoin) will need to use what kind of toothbrush? | Soft toothbrush |
| Phenytoin (Dilantin therapeutic serum rane is | 10-20 mcg/ml |
| Pt taking birth control and dilantin should be advised of? | The potential for decreased effectiveness of the birth control pills exists while taking phenytoin. |
| Carbamazepine (Tegretol) is prescribed for a patient with a diagnosis of psychomotor seizures. The nurse reviews the patients history, knowing that this medication is contraindicated if which of the following disorders is present? | liver disease |
| The nurse observes a child starting to have a seizure, after protecting the airway, what is the highest priority of the nurse? | observe and record seizure activity |
| define simple partial seizure? | consciousness not impaired, but there are other motor, sensory, autonomic or psychological problems or there is some impairment of consciousness with or without automatism (repetitive, automatic actions such as lip smacking) o |
| define generalized seizures | characterized by bilateral synchronous electrical discharges in the brain. At scene of accident ensure head and body move as one, involvement of both hemispheres,most commonly impairment of consciousness with bilateral motor involvement, NO aura (warning) |
| what is absence seizure | Also called petit mal, brief, little or no change in muscle tone, more common in children, appears to be day dreaming, no aura or warning |
| tell how EEGs are used to ID seizure activity | EEG ( electroencephalogram) Measures brain waves and ID's areas of seizure activity |
| why would CT/MRI/PET scan be done for a pt with seizures? | Can look for underlying cause of seizure |
| what factors may trigger seizures? | increased physical activity, stress, fatigue, alcohol, caffeine, some chemicals |
| Gingival hyperplasia occurs with which anti-seizure medication | Phenytoin (Dilantin) |
Created by:
starr8904
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