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

Question 1

What are seizures?

Answer 1

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

Question 2

What is epilepsy?

Answer 2

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

Question 3

T/F: Some seizures have no known etiology

Answer 3

True

Question 4

What are 4 types of generalized seizures?

Answer 4

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

Question 5

What is tonic-clonic previously referred to as?

Answer 5

Grand mal

Question 6

How long does the tonic phase last in tonic clonic?

Answer 6

10-20 seconds

Question 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 ____

Answer 7

-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

Question 8

Tonic-clonic: CLONIC phase

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

Answer 8

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

Question 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?

Answer 9

• 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

Question 10

What are absence seizures previously referred to as?

Answer 10

Petit mal

Question 11

What is the onset of absence seizures? Ceases?

Answer 11

4-12 years; ceases by puberty

Question 12

What are characteristics of absence seizures?

Answer 12

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

Question 13

Absence seizures: What kind of physical problems may appear?

Answer 13

Lip smacking
Twitching of eyelids or face
Slight hand movements

Question 14

Absence seizures: Does the person know they had it?

Answer 14

No, unable to recall episodes

Question 15

What happens with a myoclonic seizure? (5)

Answer 15

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

Question 16

What happens with atonic or akinetic seizure? (3)

Answer 16

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

Question 17

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

Answer 17

Infantile spasms

Question 18

How are the contractions with infantile spasms?

Answer 18

Sudden, brief, and symmetric muscle contractions

Question 19

How is the body during an infantile spasm?

Answer 19

Flexed head
Extended arms
Legs drawn up

Question 20

What is the eye movement like during infantile spasm?

Answer 20

Rolled upward and inward

Question 21

Is there loss of consciousness with infantile spasm?

Answer 21

Possible

Question 22

What is skin color in infantile spasm?

Answer 22

Possible flushing, pallor, or cyanosis

Question 23

What may happen before or after the infantile spasm?

Answer 23

Possible cry or giggle before or after

Question 24

Partial (focal/local)

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

Answer 24

1. Aversive seizure

2. Rolandic seizure

Question 25

Partial seizure with MOTOR signs What is aversive seizure?

Answer 25

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

Question 26

Partial seizure with MOTOR signs What is rolandic seizure?

Answer 26

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

Question 27

Partial seizure with SENSORY signs What happens?

Answer 27

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

Question 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?

Answer 28

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

Question 29

Complex partial seizure: What is complex sensory aura?

Answer 29

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

Question 30

What is the diagnostic procedure for seizures?

Answer 30

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

Question 31

When is EEG done?

Answer 31

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

Question 32

Can EEG be done with video monitoring?

Answer 32

Yes

Question 33

EEG: Pre procedure client info?

Answer 33

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

Question 34

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

Answer 34

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

Question 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 ```

Answer 35

A, B, C

Question 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

Answer 36

A

Question 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

Answer 37

A

Question 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 ```

Answer 38

A, B, C