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Flashcards in Neurologic Disorders Deck (79)
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1

Seizures

abnormal discharges in the brain for a single event of which results in an abrupt and temporary altered cerebral function state

2

Epilepsy

a disease of the brain that involves unpredictable and unprovoked seizures

3

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

4

Status Epilepticus

Continuous seizure activity for more than 5 minutes or two or more sequential seizures without full recovery of consciousness b/t seizures

5

What seizures are less likely to stop without intervention?

seizures lasting longer than 5-10 minutes

6

What type of emergency is Status Epilepticus?

a neurological emergency and can be life threatening

7

What can cause a seizure?

-Fever
-Cerebrovascular disease/Hypoxia
-Hypertension
-Head Injury
-Brain tumor
-Drug/alcohol withdrawal

8

Pathophysiology of Seizures

Brain cells continue firing electrical signals even after completing their task which equals seizure activity

9

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

10

What are focal seizures?

Start in ONE area of the brain

11

S/S of Generalized Seizures

-tonic-clonic contraction
-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

12

Tonic-Clonic Contractions

intense rigidity of the entire body followed by alternating muscle relaxation and contraction

13

What may a patient report after waking up from a seizure?

-headache
-sore muscles
-weakness
-noisy breathing
-depression

14

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..

15

What tests are used to diagnose seizure activity?

-MRI/CT
-PET
-SPECT
-EEG

16

Which tests are used to detect lesions, focal abnormalities, cerebrovascular abnormalities, and cerebral degenerative changes?

MRI/CT, PET, SPECT

17

Which test is used for diagnostic evidence for a substantial portion of patients with epilepsy and assists in classifying the type of seizures?

EEG

18

What are the goals of treatment for seizures?

-stop the seizure as quickly as possible
-ensure adequate cerebral oxygenation
-maintain seizure free state

19

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

20

What medications may be administered during an ACTIVE seizure?

**Administered IV
-Ativan (Lorazepam)
-Valium (Diazepam)
-Versed (Midazolam)

21

Antiepileptic Drugs (AEDs)

**Administered IV, Reserved for the ER
-Used to maintain a seizure free state
Dilantin (Phenytoin) and Phenobarbital

22

Why is Dilantin administered slowly through IV?

Because of the effect it has on the myocardium
-potential for arrhythmias
-will precipitate in D5W

23

What should the nurse do if a therapeutic range can NOT be maintained?

Call the doctor

24

What are the therapeutic levels for Dilantin and Phenobarbital?

D: 10-20 mg/mL
P: 10-25 mg/mL

25

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
-incontinence
-unconsciousness
-paralysis or weakness
-inability to speak
-does the patient sleep after
-cognitive status after

26

What should the nurse do if the patient is beginning to have a seizure?

-provide privacy
-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

27

Nursing Care AFTER the seizure

-keep patient on side to avoid aspiration
-reorient patient to environment
-use calm persuasion if agitated

28

Multiple Sclerosis

"disruption of flow b/t the brain and the body"

29

What is the leading cause of nontraumatic disability in young adults?

Multiple Sclerosis

30

Characteristics of Multiple Sclerosis

-Progressive demyelinating disease of the CNS
-Typically occurs b/t ages 20-40
-Women
-No known cause