Seizures

Question 1

Three major classes of seizures

Answer 1

Generalized onset
Focal onset
Unknown onset

Question 2

Generalized can be

Answer 2

motor

Non motor

Question 3

Characterized by loss of consciousness and falling to the ground

Answer 3

Tonic-Clonic seizure

Question 4

Body stiffens

Answer 4

Tonic

Question 5

Jerking of extremities

Answer 5

Clonic

Question 6

Manifestations of tonic-clonic

Answer 6

Cyanosis
Excessive salivation
Tongue/cheek biting
Incontinece

Question 7

Usually occurs only in children and rarely beyond adolescence

Answer 7

Typical absence seizure (non motor seizure; general onset)

Question 8

Timing of (typical absence seizure)

Answer 8

Brief staring spell, lasts less than 10 seconds

Question 9

Atypical absence manifestations

Answer 9

Eye blinking
Jerking movements of the lips
Lasts more than 10 seconds
Usually continue into adulthood

Question 10

Characterized by rhythmic arm abduction (3 movements per second) leading to progressive arm elevation
Usually lasts 10 to 60 seconds

Answer 10

Myoclonic seizure

Question 11

Begin in specific region of cortex in one hemisphere of brain
Produce manifestations based on function of area of brain involved

Answer 11

Focal-onset seizures

Question 12

Focal-onset seizures described by level of awareness

Answer 12

Focal awareness seizures

Focal impaired awareness seizures

Question 13

Patients remain conscious and alert

Have unusual feelings or sensations that can take many forms

Answer 13

Focal awareness seizures

Question 14

Patients have loss of consciousness or a change in awareness

Eyes are open but cannot interact

Answer 14

Focal impaired seizures

Question 15

Atonic:

Answer 15

helmet

Question 16

State of continuous seizure activity or condition when seizures recur in rapid succession without return to consciousness between seizures

Answer 16

Status epilepticus (SE)

Question 17

Neuro emergency; any type of seizure

Answer 17

Any seizure lasting longer than 5 minutes

Question 18

Prolonged or repeated tonic-clonic seizures

Answer 18

Convulsive status epilepticus

Question 19

Convulsive status epilepticus can lead to

Answer 19

respiratory insufficiency
hypoxemia
dysrhythmias
hyperthermia
 systemic acidosis

Question 20

Continuous seizure activity despite administration of first and second line therapy

Answer 20

Refractory status epilepticus (RSE)

putting them in a coma

Question 21

Immediate medical care if:

Answer 21

Status epilepticus occurs
Significant bodily harm occurs
The event is a first-time seizure

Question 22

Neurologic assessment involves testing for toxicity

Answer 22

Nystagmus
Hand and gait coordination
Cognitive functioning
General alertness

Question 23

Medical Treatment of Status Epilepticus

Answer 23

Initially, rapid-acting IV lorazepam (Ativan) or diazepam (Valium)

Question 24

diet helps control seizures

Answer 24

Ketogenic

Question 25

Precipitating factors

Answer 25

``` Metabolic acidosis or alkalosis Hyperkalemia Hypoglycemia Dehydration Water intoxication ```

Question 26

Ictal or Post-Ictal Phase

Answer 26

``` Bitten tongue, soft tissue damage, cyanosis Abnormal respiratory rate Apnea (ictal) Absent or abnormal breath sounds Airway occlusion Hypertension, tachycardia/bradycardia Bowel incontinence Excessive salivation Urinary incontinence ```

Question 27

Acute care

Answer 27

1. Open and maintain patent airway, support head, turn to side, loosen constrictive clothing, ease to floor 2. Do not restrain patient or place any objects in their mouth 3. May require positioning, suctioning, or oxygen after seizure

Question 28

Nursing management; RN

Answer 28

Teach patient about risk for seizures, drug plan Assess and record seizure details Assess and position patient and give antiseizure drugs Make appropriate referrals Collaborates with physical, occupational, or respiratory therapist

Question 29

Ambulatory Care

Answer 29

Prevention Medical alert bracelets Referrals to agencies

Question 30

Most important thing to check:

Answer 30

check for injury; bit their tongue

Question 31

Checking

Answer 31

``` RR Breath sounds airway occlusion HTN tachycardia ```

Question 32

May require what after seizure?

Answer 32

Positioning Suctioning Oxygen

Question 33

Note what during seizure:

Answer 33

the timing