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47 Cards in this Set
- Front
- Back
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seizure |
brief episode of abnormal electrical activity in the brain that is sensory, motor, or psychic neural activity , can occur alone or in combination from discharges in one or more specific area of cerebral cortex |
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convulsion |
-a manifestation of a seizure -spasmodic contractions of muscles |
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epilepsy |
recurrent pattern of seizures |
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causes of aquired seizures (ugly friends have energy but dorks have aw) |
-U uremia' -F high fever -H hypoglycemia -E electrolyte imbalances -BT brain tumor -D drug abuse -H hypoxia -AW alcohol withdrawl |
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sometimes seizures can be idiopathic |
no known cause |
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known causes of brain epilepsy 3 |
-brain injury at birth -head injuries -inborn errors of metabolism |
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partial 2 things plus 2 types |
-specific area of the cerebral cortex -can progress to generalized seizures -either (no loss of consciousness) or complex partial (with loss of consciousness) |
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elementary partial |
-does not lose conciousness -last less than one minute -motor (uncrontolled jerking movements body) -sensory (sights, sounds, mumbling, odors , nonsense words -autonomic symptoms -psychic symptoms |
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complex partial seizures |
-begins as partial seizure and progress to complex partial with loss of consciousness -loss of conciousness at onset of seizure -several sensory or motor manifestations that last less than 1 minute -after seizure client confused -automatic repetetive movements lip smacking, picking at clothing, objects (automatisms) |
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automatisms |
lip smacking picking at clothing or objects = automatic repetitive movements manifested in cpmplex partial seizures |
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pyschomotor and psychosensory are used to describe |
complex partial seizures |
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generalized seizures |
-involve the entire brain -client loses consciousness -several seconds to several mintutes -many types
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absence seizures |
-aka petit mal seizure -more common in children -brief loss of conciousness w/ cease of physical activity (lack of prominent movements) -seldom falls to ground -can have many a day -often go unnoticed -stare blankly, eyelids flutter, lips move, little movement extremities |
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myoclonic seizures |
-sudden excessive jerking of arms , legs, entire body -muscle activity can be so severe client falls to ground - are brief |
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tonic-clonic seizures |
-aka grand mal seizures -sequence of events that begins with a preictal (prodromal) phase |
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phases/events of tonic-clonic seizure 7 |
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preictal phase (prodromal) |
-time immediately before a seizure -vague emotional changes , depression, anxiety, nervousness which lasts for minutes or hours after this is aura |
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Aura phase |
-immediately after preictal phase -sensation that occurs immediately before seizure -can be sensory , hallucination odor or sound -can be sensation of weakness or numbness -usually the same sensation for the person each time |
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epileptic cry |
-takes place after aura -from contraction of the diaphram , spasm of respiratory muscles and muscles of throat and glottis -after this there is a loss of consciousness |
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loss of consciousness |
-after epileptic cry -then comes tonic clonic phase |
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tonic phase of tonic clonic phase |
-muscles contract rigidly |
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clonic phase of tonic clonic |
-muscles alternate between contraction and relaxation resulting in jerking movements and thrashing of the arms and the legs -skin cyonitic, breathing spasmodic, frothing at mouth, jaws tightly clenched, biting of tongue and cheek, urinary or fecal incontinence comon -lasts for minute or more |
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postictal phase and manifestations |
period following the tonic-clonic seizure -headache, fatigue, deep sleep, confusion, nausea, muscle soreness |
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status epilepticus |
-series of tonic-clonic seizures client does not regain consciousness between seizures -can occur spontaneously in acute neurological disorders or for no known reason -can be caused by quick stop to anticonvulsant meds, they must be withdrawn slowly -if not treated death can occur |
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atonic seizures |
-atonic means loss of muscle tone -person loses conciousness and falls to ground -rapid recovery |
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akinetic seizure |
-loss of movement , muscle tone lost briefly -client may or may not fall, rapid recovery |
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assessment |
-client's motor, sensory, neurologic functions normal except at time of seizure -to discover type of seizure witness needs to see it -neuro exam -EEG -to confirm diagnoses, CT scan MRI, serology and serum electrolyte levels |
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if epilepsy is suspected, a blank is required if first results are normal |
series of EEG are required |
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treatment seizures |
- 1 or more anticonvulsant drugs to reach optimal effect -drug therapy controls seizures or reduces their frequency or severity -dose adjusted over several week period -blood levels may be monitored for accurate adjustment and to prevent toxicity |
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carbamazepine therapy level, toxic |
theraputic 5-12 mcg/mL toxic more than 12 |
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Ethosuximide therapy level, toxic |
40-100 mcg/mL toxic more than 100 |
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Phenobarbital therapy level , toxic level |
10-30 mcg/ mL toxic more than 40 |
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Phenytoin therapy level , toxic level |
10-20 mcg/mL toxic more than 30 |
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Valproic acid therapy level, toxic level |
50-100 mcg/ mL toxic more than 100 |
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teaching Carbamazepine |
Tegretol -take with meals -dose gradually increased until relief obtained -effectiveness may decrease over time -regular dental care -assess skin daily -liver function, CBC & differential -taper dose gradually never discontinue abruptly |
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Phenytoin (Dilantin ) teaching |
-take with meals -dose gradually increased until relief obtained -effectiveness may decrease over time -regular dental care -assess skin daily -liver function, CBC & differential -taper dose gradually never discontinue abruptly -bone marrow depression so periodic lab testing -birth defects, so no pregnant |
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clients who take anticonvulsants should wear |
a medicalert bracelet naming the medications they take |
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surgical tx for seizures caused from |
-brain tumors -brain abscess -client does not respond to drug therapy with severe and frequent surgery |
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-before surgery , doctor considers |
-area of brain mapped where abnormal electrical discharges are present identified -surgeon considers whether part of brain removed would result in permanent neurodysfunction or loss of speech |
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these conditions the nurse will identify as "at risk for seizure" 5 |
-high fever -withdrawing from alcohol -hypoglycemic -hypoxia -recent head injury |
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for at risk seizure the following items at bedside 3 |
-suction -oral airway -oxygen equipment |
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bed for risk for seizure 3 |
-pad rails -pad headboard -bed in low position |
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when seizure occurs |
-position client on side -restrict loose clothing -airway is kept patent -suction if necessary -provide oxygen during seizure |
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after the seizure the nurse |
-inspects mouth & teeth for injuries -cleans up if incontince occured -document situation preceded seizure -duration of seizure -parts of body involved in seizure -vital signs , oxygen saturation, blood glucose if indicated |
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this vitamin must be given with anticonvulsants |
Vit D. Anticonvulsants impair VIT D metabolism leading to calcium imbalance, rickets, osteomalacia |
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ketogenic nutrition for seizures |
high fat diet 80-95% of daily calories of diet are fat this diet for children only . included mild dehydration which concentrates blood keytones |
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seizure assessment data checklist |
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