Seizures

Question 1

Diagnostic procedures

Answer 1

EEG, MRI, CAT scan, Blood tests, Lumbar puncture, Spect

Question 2

EEG

Answer 2

Records electrical patterns of brain, identifies seizure type, identifies focus or source of seizure

Question 3

EEG nursing actions

Answer 3

explain test, make sure hair is clean, electrodes will be attached to scalp with paste, instruct parents that child may have seizure during test

Question 4

Cat scan

Answer 4

computerized tomography, contrast dye may be injected, computerized photos of brain are shown

Question 5

Cat scan nursing actions

Answer 5

explain procedure, check for allergies (iodine), kids may receive a sedative bc they have to lie still for a long time, no special prep

Question 6

Blood tests

Answer 6

cbc, electrolytes, liver function studies(gotta know this!)

Question 7

Lumbar puncture (spinal tap)

Answer 7

performed to diagnose infection, removal of CSF by needle aspiration

Question 8

Lumbar nursing actions preprocedure

Answer 8

written consent explained by dr with nurse as witness, determine patient ?s, have patient go to bathroom prior

Question 9

Lumbar nursing actions during procedure

Answer 9

assist patient in position on side (knee to chest) or sitting up (chest down to knees with back arched like a cat), nurse holds patient to help maintain position entire time of procedure

Question 10

Lumbar puncture nursing actions postprocedure

Answer 10

refer to hospital policy, research no definite benefits to bedrest after a spinal tap, bedrest is determined by dr doing spinal tap, monitor for complications: H/A, voiding difficulties, increased temp, backache, neck stiffness

Question 11

Lumbar puncture complications

Answer 11

H/A after sitting up bc dr took too much CSF out. In order to stop it they have to inject patients own blood in spinal column, voiding difficulties, increased temp, backache, stiffness of neck, Rare: herniation of brain contents, spinal abscess, spinal hematoma, meningitis

Question 12

Status Epilepticus

Answer 12

a series of generalized seizures that occur without full recovery of consciousness between attacks. Medical emergency. can last 30 mins

Question 13

SPECT diagnostics

Answer 13

helps identify epileptic zone so it can be removed in surgery

Question 14

Partial seizures

Answer 14

focal seizure, involve one area of brain

Question 15

types of partial seizures

Answer 15

simple partial seizures & complex partial seizures

Question 16

Simple partial seizures

Answer 16

remains conscious, usually reports aura, eyes/head turn from side of focus, psychic experiences, smells, pain

Question 17

Complex partial seizures

Answer 17

loss of consciousness (few secs), unaware of behavior, don’t remember event when its over, involves series of rxns or emotional changes (ex they might just cry), complex sensory changes (Hallucinations, mental distortion, changes in personality), involuntary urination, chewing/lip smaking, diarrhea, onset usually late teens

Question 18

Grand mal also called

Answer 18

tonic-clonic

Question 19

Petit mal also called

Answer 19

absence seizures

Question 20

Generalized seizures

Answer 20

both hemispheres are involved so you get a loss of consciousness

Question 21

Generalized seizures examples

Answer 21

Tonic-clonic, Absence, Myoclonic, Febrile, Status Epilepticus

Question 22

Tonic-clonic 4 phases

Answer 22

aura, tonic, clonic, postictal

Question 23

Aura phase

Answer 23

subjective, may happen hrs before actual seizure, recognizable sensation before a seizure-signals to patient that their going to have seizure

Question 24

tonic phase

Answer 24

10-20 secs involuntary muscular tension or contraction during seizure. Immediate loss of consciousness resulting in falls

Question 25

clonic phase

Answer 25

30 secs. alternately contracting and relaxing the muscles during a seizure. Appears as an aggressive spasm

Question 26

Postictal phase

Answer 26

occurs AFTER seizure, may have symptoms of H/A, sleep, amnesia, remain confused for several hrs, speech probs, this phase is reflective of what type of seizure that has occurred, recovery phase

Question 27

Neonate examples of known causes of having seizures

Answer 27

Trauma & anoxia, metabolic disorders (hypoglycemia <40), Neonatal infection (herpes), Kernicterus

Question 28

Febrile seizures temp

Answer 28

102-104: give kid motrin at night bc it lasts longer, cool kid down with tepid(lukewarm) h2o, have kid see dr to rule out meningitis, EEG is usually normal

Question 29

Antiepileptic meds can do what to fetus?

Answer 29

create fetal anomalies

Question 30

Females are most likely to have a seizure during what?

Answer 30

seizures increase during periods

Question 31

Absence seizures

Answer 31

involve abrupt 3-5 sec periods of loss of consciousness, loss of consciousness seems like they are day dreaming, more common in kids, usually no muscle involvement, seldom falls, no incontinence, amnesia for episode may need to repeat whatever was said during episode

Question 32

Absence seizures start at what age?

Answer 32

3 & frequently disappear by puberty

Question 33

Atonic (Akinetic) seizures

Answer 33

sudden loss of muscle tone (can slip under water if in bath), unable to break fall, injury could result, momentary loss of consciousness

Question 34

Myoclonic seizures

Answer 34

short, sporadic periods of muscle contractions that last for several minutes, no loss of consciousness, no postictal state, are, often secondary seizures, can be asymmetrical or symmetrical

Question 35

Status Epilepticus treatment/nursing actions

Answer 35

notify DR immediately, establish patent airway, apply o2 as warranted, IV Valium (Diazapam) or Ativan as ordered, IV Dilantin (Phenytoin) and Phenobarbital may be ordered

Question 36

Why is IV Valium (Diazapam) or Ativan ordered during a Status Epukepticus?

Answer 36

to stop motor movement -check respiration status frequently

Question 37

When giving IV Dilantin (Phenytoin) never give more than ___mg/hr to prevent cardiac arrhythmias

Answer 37

50mg/hr

Question 38

What is used as a last resort for treatment of Status Epilepticus?

Answer 38

General anesthesia

Question 39

AFTER Status Eilepticus is over what are some nursing actions?

Answer 39

side-lying position, insertion of N/G tube to prevent aspiration, monitor BP & cardiac status, prevent hyperthermia, observe for s/s of med toxicity

Question 40

Surgical interventions for Status Epilepticus

Answer 40

corpus callostomy is severed, removal of sections or lobes of brain responsible (focus) for seizure activity

Question 41

Nursing diagnosis: Potential for Injury goal and nursing actions

Answer 41

Goal: Patient will be free from injury if seizure occurs. Nursing actions: 02 & suctioning at bedside, IV access, Padded side rails

Question 42

Nursing diagnosis: Ineffective coping goal and nursing actions

Answer 42

Goal: patient will begin to develop strategies to cope with diagnosis before discharge. Nursing actions: support, identify past coping strategies, relieve anxiety thru teaching

Question 43

An example of a barbiturate antiseizure med

Answer 43

Phenobarbital