Beth - Week 7 - Exam 3 Flashcards

(30 cards)

1
Q

what is a seizure?

A

uncontrollable; excessive firing of hyperexcitable neurons

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2
Q

what is epilepsy?

A

recurring sezures

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3
Q

why do seizures occur?

A

abnormal foci in the brain; a symptom of pathology; don’t know why; could be head injury to stroke, meningitis → seizure → infections in brain

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4
Q

T/F if the entire cerebral cortex is involved → unconscious

A

YES TRUTH

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5
Q

what are the risk factors for seizures? look at case study also

A
  • idiopathic
  • birth trauma; congenital
  • sensory overload (flashing)
  • head trauma; tumor
  • meningitis; encephalitis
  • hyperthermia
  • metabolic (electrolyte imbalance/hypoglycemia/stroke)
  • CVA
  • drug and/or ETOH withdrawal
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6
Q

what are the classifications of seizures?

A

generalized or partial (new) focal

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7
Q

what is a one generalized seizure called?

A

tonic - clonic (grand mal)

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8
Q

what are the sxs of tonic - clonic seizures?

A
  • Aura-may or may not feel it coming
  • Loss of consciousness
  • Tonic movement
  • Clonic movement
  • B & B incontinence
  • Tongue biting
  • Salivation
  • Post-Ictal Phase
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9
Q

what are the sxs of a T-C seizure post ictal phase?

A

H/A, sore, tired, amnesia, difficulty to arouse

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10
Q

what is another generalized seizure called?

A

absence (petite mal)

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11
Q

what are the sxs of an absence seizure?

A
• Interruption of consciousness
• Seen in pediatrics
• Staring spells
• “vacant stare`
• Altered awareness or loss of environmental
contact
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12
Q

what are the characteristics of a partial (focal) simple seizure?

A
• No loss of consciousness
• Motor: Single muscle group progressing to
adjacent muscle groups
• Sensory-senses
• Autonomic
• Déjà vu
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13
Q

what are the characteristics of a partial (focal) complex seizure “temporal lobe epilepsy” “pysychomotor”?

A
• Has impaired level of consciousness
• Simple → Complex
• Unaware
• Bizarre behavior
- Lip smacking
- Automatism or automatic movement
- consistent - look like looking actively but it's automatic
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14
Q

who is most susceptible to a febrile seizure?>

A
  • young children with high temps
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15
Q

what is the treatment for febrile?

A

tylenol, tepid bath, IV/rectal if vallium necessary

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16
Q

what is the nursing role for seizures?

A
  • Risk Factors
  • Patient Assessment
  • Patient Safety
  • Ongoing Assessment
17
Q

what is the medical management for all types of seizures?

A
• Goal: Prevention and Protection
• Assess seizure for type & duration
(before, during, after)
• Protect from injury (public or hospital)
• Administer anti-epileptic drugs
• check serum drug levels
• Assess and Reassess
18
Q

what are the anti-epileptic drugs that are voltage-dependent sodium channels?

A
Carbamazepine
Phenytoin
Lamotrigine
Oxcarbazepine
Zonisamide
Lacosamide
Rufinamide
Eslicarbazepine
19
Q

what are the anti-epileptic drugs that affect GABA activity?

A

Phenobarbital
Tiagabine
Vigabatrin
Benzodiazepines

20
Q

what are the anti-epileptic drugs that have multiple mechanisms of action?

A

Valproate
Felbamate
Topiramate

21
Q

what are the anti-epileptic drugs that have other mechanisms of action?

A
Gabapentin
Pregabalin
Levetiracetam
Brivaracetam
Ezogabine
22
Q

what is the surgical management for seizures?

A
  • Local resection
  • Temporal lobectomy
  • Implanting a pulse generator
  • Vagal Nerve Stimulator
23
Q

what is the diagnostic study for seizures?

A

electroencephalogram (EEG)
• Detects electrical activity in the brain
• Brain cells communicate via electrical impulses which show as wavy lines on a graph

24
Q

what are the nursing considerations for an EEG?

A
  • no caffeine
  • Make sure pt eats
  • Withold tranquilizers if a sleep deprived EEG
  • Can the pt. have their anticonvulsants?—when should you give them?
  • No sedations
25
what is status epilepticus?
a medical emergency - prolonged seizure w/o regaining consciousness for at least 30 minutes
26
what do you see during status epilepticus?
* increased metabolic demand * venous congestion * brain hypoxia
27
what are the precipitating factors for status epilepticus?
* withdrawal of epileptic drugs * fever * infection * imbalance in glucose or electrolytes?
28
what is the management of status epilepticus?
``` • Adequate oxygenation • may intubate if airway compromised • Start/monitor an IV • Control the seizure activity with __________________________ • Protect from injury • Administer anti-epileptic drugs as ordered • check serum drug levels • Assess and Reassess ```
29
what is the family teaching for status epilepticus?
``` • When can pt. drive? - seizure free for a year • Oral care • Showers not tub bath • Take meds daily to keep drug levels up • Blood samples • teach risk factors • Life style modifications • Make sure meds are regulated • Women can have healthy babies • ID tags with name of drugs • Resources • Compliance • Discuss the issue of not being overprotective ```
30
what are the lifestyle modications for status epilepticus?
* adequate sleep * avoid ETOH; talk to MD about OTC drugs * use relaxation techniques * awareness of aura * awareness of emotional disturbances