Ch. 13: Seizures Pt. 1-Types of Seizures Flashcards Preview

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Flashcards in Ch. 13: Seizures Pt. 1-Types of Seizures Deck (38):
1

What are seizures?

Abnormal, excessive electrical discharges of neurons within the brain caused by a disease process

2

What is epilepsy?

Chronic, recurring, and diagnosed after all other possible etiologies for seizures have been ruled out

3

T/F: Some seizures have no known etiology

True

4

What are 4 types of generalized seizures?

1. Tonic-clonic
2. Absence
3. Myoclonic
4. Atonic or akinetic

5

What is tonic-clonic previously referred to as?

Grand mal

6

How long does the tonic phase last in tonic clonic?

10-20 seconds

7

Tonic-clonic: TONIC PHASE

-What happens to eyes?
-Is there loss of consciousness?
-How is the tonic contraction?
-Any sort of cry?
-Increased ____
-What goes on with swallowing reflex?
-___ leading to ____

-Eyes roll UPWARD
-Yes, there is loss of consciousness
-Tonic contraction of ENTIRE body; arms=FLEXED and
legs, head, and neck=EXTENDED
-Possible PIERCING cry
-Increased salvation
-Swallowing reflex=Lost
-Apnea leading to cyanosis

8

Tonic-clonic: CLONIC phase

-How long does it last?
-What may happen with the mouth?
-May be ____
-Gradual ____ of movements until cessation

-Time varies
-Foaming of mouth
-May be INCONTINENT
-Gradual SLOWING of movements until cessation

9

The last part of the tonic-clonic seizure is the postictal state. Several things happen here:

-How is arousal: easy or difficult?
-How long is pt. confused?
-Impairment of fine or gross motor skills?
-Lack of ?
-Possible what?
-Sleeps for how long?
-Any relocation of the seizure?

-Arousal=dificult
-Pt confused HOURS
-Impairment= fine motor skills
-Lack of coordination
-Possible vomiting, headache, visual or speech difficulties
-Sleeps several hours
-No relocation of seizure

10

What are absence seizures previously referred to as?

Petit mal

11

What is the onset of absence seizures? Ceases?

4-12 years; ceases by puberty

12

What are characteristics of absence seizures?

-Loss of consciousness lasting 5-10 seconds
-Minimal to no change in behavior
-Resemble daydreaming
-May drop items in hand

13

Absence seizures: What kind of physical problems may appear?

Lip smacking
Twitching of eyelids or face
Slight hand movements

14

Absence seizures: Does the person know they had it?

No, unable to recall episodes

15

What happens with a myoclonic seizure? (5)

-Variety of seizure episode
-Symmetric or asymmetric involvement
-Breift contractions of muscle or muscle groups
-No postictal state
-May or may not loose consciousness

16

What happens with atonic or akinetic seizure? (3)

-Muscle tone lost for a few seconds
-Period of confusion follows
-Loss of muscle tone frequently results in falling

17

What seizure is most common during first 8 months of life?

Infantile spasms

18

How are the contractions with infantile spasms?

Sudden, brief, and symmetric muscle contractions

19

How is the body during an infantile spasm?

Flexed head
Extended arms
Legs drawn up

20

What is the eye movement like during infantile spasm?

Rolled upward and inward

21

Is there loss of consciousness with infantile spasm?

Possible

22

What is skin color in infantile spasm?

Possible flushing, pallor, or cyanosis

23

What may happen before or after the infantile spasm?

Possible cry or giggle before or after

24

Partial (focal/local)

What are the two types of simple partial seizures with MOTOR signs?

1. Aversive seizure
2. Rolandic seizure

25

Partial seizure with MOTOR signs

What is aversive seizure?

Eyes and head turn away from the side of focus, with or without loss of consiousness

26

Partial seizure with MOTOR signs

What is rolandic seizure?

Tonic-clonic movemnts involving the FACE; most common during SLEEP

27

Partial seizure with SENSORY signs

What happens?

-Tingling
-Numbness or pain in one area of the body--then spreading to other body parts with VISUAL sensations

28

Complex partial seizures:

-What kind of behavior?
-____ to respond to environment
-What kind of consciousness: lost, impaired, or intact?
-Any confusion?
-Can they recall event?

-Behavior= altered
-INABILITY to respond to environment
-Consciousness: Impaired
-Confusion? YES
-Recall event? NO

29

Complex partial seizure:

What is complex sensory aura?

Strange feeling in stomach that rises to throat
Auditory or visual hallucinations
Feelings of fear
Distorted sense of time and self

30

What is the diagnostic procedure for seizures?

EEG to record electrical activity and may identify origin of seizure activity

31

When is EEG done?

Can be done during sleep, when awake and with stimulation and hyperventilation

32

Can EEG be done with video monitoring?

Yes

33

EEG: Pre procedure client info?

1. No caffeine for several hours prior
2. Wash hair before (don't put in oils or spray) and after *after to remove electrode gel
3. Let client know they may be asked to take deep breaths and/or be exposed to flashes of light during procedure

34

EEG: Pre procedure..Why may client be asked to withold sleep prior to procedure?

Sleep may be withheld prior to test and be induced during test if the doc wants the client to be tested while sleeping

35

A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect? (SATA)

A. Loss of conscious
B. Appearance of daydreaming
C. Dropping held objects
D. Falling to floor
E. Having a piercing cry

A, B, C

36

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for nurse to take?

A. Maintain side lying position
B. Monitor VS
C. Reorient child to environment
D. Assess for injuries

A

37

A nurse is providing teaching to the parent of a child who is to have an EEG. Which of the following should be included in teaching?

A. Decaffeinated beverages should be offered on morning of procedure
B. Do not wash childs hair night before procedure
C. Withhold all foods morning of procedure
D. Give you child an analgesic night before

A

38

A nurse is teaching a group of parents about risk factors for seizures. Which of following should be included in teaching? (SATA)

A. Febrile episodes
B. Hypoglycemia
C. Sodium imbalances
D. Low serum lead levels
E. Presence of diphtheria

A, B, C