Ch. 13: Seizures Pt. 2-Care and Complications of Seizures

Question 1

What are seizure precautions we need to initiate for any child at risk?

Answer 1

1. Pad side of bed, crib, and wheelchair
2. Keep bed free of objects that could cause injury
3. Have suction and oxygen equip available

Question 2

During seizure, if patient has seizure on floor what do we do?

Answer 2

Hold head in lap

Question 3

During seizure..what position is best?

Answer 3

A position that maintains a patent airway & turn client to side to decrease risk of aspiration

Question 4

During seizure..is it ok to restrain the child for safety?

Answer 4

NO do not attempt to restrain the child!

Question 5

Is it ok to open the jaw during the seizure or insert an airway?

Answer 5

No!! This may damage teeth, lips, or tongue

Question 6

T/F: Using padded tongue blades helps prevent damage to the oral cavity during a seizure

Answer 6

FALSE; do not use padded tongue blades during a seizure

Question 7

If a patient wears glasses and they are having a seizure, should we leave them on or take them off?

Answer 7

Take off

Question 8

During seizure. What should we note?

Answer 8

• Onset
• Time
• Characteristics

Question 9

During seizure..How should we allow the seizure to end?

Answer 9

Spontaneously

Question 10

Post-seizure. What position and why?

Answer 10

Side-lying…to prevent aspiration and to facilitate drainage of oral secretions

Question 11

What injuries should we asses for?

Answer 11

All types, but don’t forget to include the mouth (tongue and teeth)

Question 12

Post-seizure: What should we note?

Answer 12

Time of postictal period

Question 13

Do we remain with client during seizure?

Answer 13

Yes

Question 14

Do we remain with client after seizure?

Answer 14

Yes

Question 15

Post seizure: When is it ok to administer food or liquid?

Answer 15

When the client is completely awake and swallow reflex is present

Question 16

Post seizure: What should we determine?

Answer 16

If client experience an aura –which may indicate the origin of seizure in the brain

Question 17

What class of drugs are given for seizures?

Answer 17

Anti epileptic drugs (AED)

Question 18

What are examples of antiepoleptic drugs?

Answer 18

Diazepam
Phenytoin
Carbamazepine
Valproic acid
Fosphenytoin sodium

Question 19

Client education about meds?

Answer 19

• TAKE AT SAME TIME EVERY DAY to enhance effectiveness
• Be aware of food interactions
• Teach adverse effects

Question 20

What is a ketogenic diet?

Answer 20

High fat
Low carb
Adequate protein

Question 21

What are some surgical interventions for seizures (4)?

Answer 21

1. Removal of tumor, lesion, or hematoma
2. Focal resection of an area of the brain to remove epileptogenic zone
3. Hemispherectomy: Removal of one hemisphere of brain
4. Corpus callostomy: Separation of two hemispheres in brain

Question 22

VNS (vagal nerve stimulation): Where is the stimulation implanted and where is it connected?

Answer 22

Implanted: left chest wall

Connect to: An electrode that is placed at the LEFT vagus nerve

Question 23

How does VNS work to control seizures?

Answer 23

Device is programmed to administer intermittent VNS at rate specific to clients needs

The client may initiate VNS by holding a magnet over device at onset of seizure activity–this will either abort seizure or lessen its severity

Question 24

What lab tests should be periodically monitored?

Answer 24

AED (antiepiletic drugs)

Question 25

Inform the client about possible medication interactions. Ex?

Answer 25

The AEDs can cause decreased effectiveness of oral contraceptives!

Question 26

What are some complications?

Answer 26

Status epilepticus

Developmental delays

Question 27

Status epliepticus (SE): Seizure activity that lasts longer than ____ OR a _____ activity in which client DOES NOT enter a postictal phase

Answer 27

Longer than 30 MIN or a CONTINUOUS seizure

*this acute condition requires immediate treatment to prevent loss of brain function

Question 28

SE: Nursing actions?

Answer 28

1. Maintain airway
2. Adminsite O2
3. Get IV access
4. Do ECG monitoring
5. Monitor Pulse Ox and ABG

Question 29

SE: As prescribed, administer a loading dose of ____ or _____. If seizure continues after loading dose is given ____ followed by ____ should be administer

Answer 29

SE: As prescribed, administer a loading dose of DIAZEPAM or LORAZEPAM. If seizures continue after the loading dose is given, FOSPHENYTOIN followed by PHENOBARBITAL should be administered

Question 30

A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following should be included in discussion? (SATA)

A. VNS
B. Additional AED meds
C. Corpus callostomy
D. Focal resuction
E. Radiation theapy

Answer 30

A, B C, D