Flashcards in Neurologic Disorders Deck (79)
abnormal discharges in the brain for a single event of which results in an abrupt and temporary altered cerebral function state
a disease of the brain that involves unpredictable and unprovoked seizures
What conditions must a person meet to be considered Epileptic?
-at least two unprovoked seizures occurring more than 24 hours apart
-1 unprovoked seizure and the probability of more
-diagnosis of epilepsy syndrome
Continuous seizure activity for more than 5 minutes or two or more sequential seizures without full recovery of consciousness b/t seizures
What seizures are less likely to stop without intervention?
seizures lasting longer than 5-10 minutes
What type of emergency is Status Epilepticus?
a neurological emergency and can be life threatening
What can cause a seizure?
Pathophysiology of Seizures
Brain cells continue firing electrical signals even after completing their task which equals seizure activity
S/S of FOCAL Seizures
-may or may not retain awareness
-May talk unintelligibly/may be dizzy
-May remain motionless or move inappropriately
-Experience excessive emotions of fear, elation, or irritability
-Will not remember the episode when its over
What are focal seizures?
Start in ONE area of the brain
S/S of Generalized Seizures
-may bite tongue or inner cheek
-may be incontinent
-After 1-2 minutes convulsive movements subside and patient relaxes into deep coma
-May be confused after and sleep for hours
intense rigidity of the entire body followed by alternating muscle relaxation and contraction
What may a patient report after waking up from a seizure?
How is a medical diagnosis of seizures made?
The patient is asked about common triggers associated with seizures which may be: odors, visuals, auditory, lack of sleep, hypoglycemia, stress, illness, alcohol/drug use, etc..
What tests are used to diagnose seizure activity?
Which tests are used to detect lesions, focal abnormalities, cerebrovascular abnormalities, and cerebral degenerative changes?
MRI/CT, PET, SPECT
Which test is used for diagnostic evidence for a substantial portion of patients with epilepsy and assists in classifying the type of seizures?
What are the goals of treatment for seizures?
-stop the seizure as quickly as possible
-ensure adequate cerebral oxygenation
-maintain seizure free state
What does the nurse do during an active seizure?
-Administer oxygen via N/C
-Monitor pulse oximetry
-May suction the airway
-Ensure patent IV line
-VS taken q 1-2 hours
What medications may be administered during an ACTIVE seizure?
Antiepileptic Drugs (AEDs)
**Administered IV, Reserved for the ER
-Used to maintain a seizure free state
Dilantin (Phenytoin) and Phenobarbital
Why is Dilantin administered slowly through IV?
Because of the effect it has on the myocardium
-potential for arrhythmias
-will precipitate in D5W
What should the nurse do if a therapeutic range can NOT be maintained?
Call the doctor
What are the therapeutic levels for Dilantin and Phenobarbital?
D: 10-20 mg/mL
P: 10-25 mg/mL
What should the nurse document during a seizure?
-circumstances before seizure
-occurrence of an aura
-the first thing a patient exhibits in the seizure, conjugate gaze position, and the position of the head at the beginning
-types of movement
-duration of seizure
-paralysis or weakness
-inability to speak
-does the patient sleep after
-cognitive status after
What should the nurse do if the patient is beginning to have a seizure?
-ease the patient to the floor if not in bed
-protect the head
-remove eye glasses and loose clothing
-raise side rails and place on side in bed
-have suction available
-DO NOT attempt to open the patients mouth
-DO NOT attempt to restrain the patient
Nursing Care AFTER the seizure
-keep patient on side to avoid aspiration
-reorient patient to environment
-use calm persuasion if agitated
"disruption of flow b/t the brain and the body"
What is the leading cause of nontraumatic disability in young adults?