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54 Cards in this Set
- Front
- Back
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Generalizes seizures: involve 1 or 2 hemispheres
what are examples of these seizures |
2
tonic-clonic |
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Generalizes seizures
-tonic-clonic seizure lasts how long? -it begins with the TONIC phase, which causes what? |
2-5 minutes
causes stiffening or rigidity of the muscles (arms and legs) and immediate loss of consciousness |
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Generalizes seizures
-tonic-clonic seizure -after the tonic seizure, the clonic part follows which presents as what |
jerking of all extremities follows.
the patient may bite his or her tongue and may become incontinent of urine or feces |
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Tonic or Clonic seizure
an abrupt increase in muscle tone, loss of consciousness , and autonomic changes lasting from 30 seconds to several minutes |
tonic
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Tonic or Clonic seizure
can result from water intoxication |
tonic
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Tonic or Clonic seizure
commonly occur during sleep |
tonic
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Tonic or Clonic seizure
-Muscle tone increases abruptly or gradually, causing muscles to stiffen. |
tonic
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Tonic or Clonic seizure
The seizures typically last only 10 to 15 seconds but can cause people, if standing, to fall to the ground. |
tonic
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Tonic or Clonic seizure
-loss of consciousness. |
tonic
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-This tonic seizure that occurs nonstop .
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status epilepticus
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Tonic or Clonic seizure
lasts several minutes and causes muscle contraction and relaxation |
clonic
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When a person is having tonic/clonic seizure (contraction and stiffness), are they breathing?
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they are not breathing and they become hypoxic and they are using up mass quantities of glucose with all that muscles that contracting.
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When a person is having tonic/clonic seizure, what does the massive contracting of the muscle do?
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increases the core temp in the body and uses up glucose (hypoglycemia is common)
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When a person is having tonic/clonic seizure, what is the nursing priority?
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airway, breathing, HR, temp (axillary, tympanic, rectal), and whats their glucose..hypoglycemia is common
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Partial seizures, also called focal or local seizures, begin where
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in a part of 1 cerebral hemisphere
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Partial / focal / local seizures
are divided into 2 main categories |
complex partial and simple partial
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures may cause LOC (syncope) or “black out” for 1 to 3 minutes |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures the pt is unaware of the envt and may wander at the start of the seizure. |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures in the period after the seizure, he or she may have amnesia (loss of memory) |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Abnormal electrical discharges begin in a small area of the temporal lobe or frontal lobe and quickly spread to other nearby areas. |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures –The seizures usually begin with an aura (ex: smell, shooting lights) that lasts 1 to 2 minutes. |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Stare (focal) |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Chew or smack the lips involuntarily |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Move the hands, arms, and legs in strange, purposeless ways |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Utter meaningless sounds (in focal seizures, they are breathing) |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Not understand what other people are saying b/c they are not consciously aware |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Resist help |
complex partial seizures
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures the pt remains conscious throughout the episode. |
simple partial seizure:
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures he or she often reports an aura (unusual sensation) before the seizure takes place. |
simple partial seizure:
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures during the seizure, the pt may have 1 sided movement of an extremity, experience unusual sensations, or have autonomic symptoms (change in HR, skin flushing, and epigastric discomfort) |
simple partial seizure:
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures Abnormal electrical discharges begin in a small area of the brain and remain confined to that area. –Because only a small area of the brain is affected, symptoms are related to the function controlled by that area. |
simple partial seizure
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures not affecting awareness or memory |
simple partial seizure
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Partial-focal-local seizures
complex partial seizures OR simple partial seizures example: finger tapping |
simple partial seizure
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epileptic seizures vs nonepileptic seizures
which have no apparent cause (or trigger) and occur repeatedly |
epileptic
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epileptic seizures vs nonepileptic seizures
these seizures are triggered (provoked) by a disorder or another condition that irritates the brain (ex: a fever) |
nonepileptic
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cause of seizures:
before age 2 |
high fevers or temporary metabolic abnormalities (high glucose, calcium, magnesiu, vitamin b6, sodium)
seizures do not occur once the fever or abnormality resolves. if it does reoccur, high chance of injury during birth or brain disorder |
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cause of seizures:
age 2-14 |
cause is unknown
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cause of seizures:
after age 25 |
head injury (edema or bleed)
stroke or tumor alcohol withdrawal unknown |
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what is status epilepticus:
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prolonged seizure lasting longer than 5 minutes or repeated seizures over the course of 30 minutes
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Medications for acute seizure
-what are given during a seizure? |
Antiepileptic drugs (AKA anticonvulsants)
Lorazepam, diazepam, diastat, valium or ativan during seizure |
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to prevent additional tonic-clonic seizures or cardiac arrest, a loading dose of _____________ is given
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IV phenytoin (Dilantin)
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how do you stop seizures?
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Benzodiazepine
--Diazapam (Valium) will stop acute seizure because they sedate brain. Given IV push --Lorazapam (Ativan) will stop acute seizure because they sedate brain. Given IV push |
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Non-acute (maintenance) for seizures
2 main drugs are what? |
carbamazepine (Tegretol)
phenytoin (Dilantin) |
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Phenytoin (dilantin) or _____________ are given to keep seizures from happening
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fosphenytoin
-phenytoin – cardiac monitor, infused over a period of time..fosphenytoin is safe, has to be infused over an hour, it burns bad when being infused, the pH causes it to burn |
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What are seizure precautions
make sure that what 3 things are readily available |
oxygen
suctioning equipment with an airway are readily available. if the pt does not have an IV access, |
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What are seizure precautions
what should you do if the pt does not have an IV access? |
insert a saline lock which will provide ready access if IV drug therapy must be given to stop the seizure
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What are seizure precautions
when can you use oxygen? what are other precautions |
Oxygen (only when coming out of seizure) suction equipment, airway, IV access, padded side rails, no tongue blades)
-placing a mattress on the floor may be used instead of site rails |
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What actions does a nurse perform to ensure safety of a patient who is seizuring
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-Turn patient on side because they may lose consciousness
-if possible turn pts head to the side to prevent aspiration and allow secretions to drain -remove any objects that might injure the patient -protect pt from injury -do not force anything into pts mouth -turn the pt to the side to keep the airway clear -loosen any restrictive clothing the pt is wearing -maintain the pts airway and suction as needed -do not restrain or try to stop the pts movement, guide movements if necessary |
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What does the nurse assess after an acute seizure is over
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-take the pts vitals
-perform neurologic checks -keep the pt on his or her side -allow the pt to rest -document the seizure |
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after an acute seizure is over, what is drawn?
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blood is dawn to determine arterial blood gas levels and to identify metabolic, toxic, and other causes of uncontrolled seizure.
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after an acute seizure is over, what should you evaluate?
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-evaluate blood levels of the drug, administer dilantin (pt must be cardiac on monitor), health teaching, importance of compliance to medications
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Phenytoin - Dilantin
tell me about this drug what are some adverse effects |
Action potential suppressed stop excitability
Reduced voltage, frequency, and spread of electrical discharges in the motor cortex Dilantin is a maintenance med, you don’t give it to stop seizure Sedation Confusion Nystagmus Test Overgrowth of gums hyperplasia. Make sure they have dental care/flossing Teratogenic effects |
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what type of seizure is cyanosis is common in because they are not breathing
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tonic clonic
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if the patient is having a simple partial seizure, what should the nurse do
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observe and redirect
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