T3-Blueprint: Seizures Flashcards Preview

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Flashcards in T3-Blueprint: Seizures Deck (63):
1

Seizure manifestation can be caused by?

Hyponatremia
Hypernatremia
Late: Hypoglycemia

2

Where does a partial seizure arise from?

Any area of cerebral cortex (frontal, parietal, temporal most affected)

3

Partial: characterized by what? (4)

-Localized motor symptoms
-Somatosensory
-Psychic
-Autonomic symptoms

*or a combo

4

What is the key sign of a partial seizure?

Child starts picking at his/her clothes

5

The key sign to a child have a partial seizure is the child picking at their clothes. What are some other signs and characteristics?

-May have an aura before
-Lasts a minute or two
-May create automatic movements child is unaware of

6

What are the 3 types of partial seizures?

1. Simple partial seizure
2. Complex partial seizure
3. Simple or complex seizures secondarily generalized

7

What is a simple partial seizure?

Simple symptoms and no alteration of consciousness

8

What is a complex partial seizure?

Complex symptoms and impairment of consciousness

9

What is a simple or complex seizure secondarily generalized?

Simple or complex seizures that evolve into generalized (tonic clonic usually)

10

What type of seizure is a tonic clonic (grand mal)?

Generalized

11

What can cause a tonic clonic seizure?

Febrile seizures

12

Generalized: How long does tonic phase of tonic clonic last and what is tonic?

Lasts 10-20 seconds

Stiffening of the body

13

Generalized: How long does clonic phase of tonic clonic last and what is clonic?

Lasts 30 seconds (or longer)

Clonic muscle activity

14

Generalized: What are classic seizure symptoms of tonic clonic?

-Eyes roll upward
-Immediate LOC
-Falls to ground
-Stiffening of body
-Tonic contraction of body, flexed harms, legs/head/neck extended
-May utter a cry
-Increased salivation

15

Generalized: Tonic clonic

Is there moderate or violent jerking?

Jerking

16

Generalized: tonic clonic

What happens at the mouth?

Foaming at the mouth

17

Generalized: Tonic clonic

What goes on with GI tract?

Incontinence of urine and feces

18

What is parent education regarding children with tonic clonic seizures?

Make sure the teachers know to cover the child up, let the class out for recess after an attack so the child isn't embarrassed

19

Generalized: What are 4 phases of tonic clonic and what happens with each?

1. Aura phase
-early seizure phase
2. Tonic phase
-Stiffening
3. Clonic phase
-Jerking
4. Postloctal
-After seizure; sleepy, but able to be aroused

20

Continuous seizure that lasts more than 30 minutes or a series of seizures

Statis elepticus

21

T/F: The child regains consciousness during a status elepticus attack

FALSE--it is too brieft to allow the child to regain consciousness between the time one event ends and the next begins

22

What is the danger with status elepticus seizures?

Cardiac arrest and brain damage

23

Generalized: What age to absence (petit mal) usually occur?

4-12

24

Generalized: Absence--Who is it more common in? When does it cease?

Girls; puberty

25

Is there a LOC with absence?

Yes brief--5-10 seconds

26

What are some characteristics of absence seizures?

-Minimum/no muscle tone loss
-May drop a held object
-20+ attacks daily

27

T/F: Absence seizures may even go unrecognized unless watching for it

TRUE--absence are mistaken for inattentiveness or daydreaming

28

Absence seizures have a slow onset?

No--abrupt onset with 20 or more attacks daily!!

29

Absence: ____ for episdoe

Amnesia

30

What is another name for atonic and akinetic seizures?

Drop attacks

31

What is the onset for atonic and akinetic (drop attack) seizures?

2 and 5 years old onset

32

Define atonic and akinetic (drop attack)?

Sudden, momentary loss of muscle tone and postural control

33

Atonic and akinetic (drop attack): When does this normally occur?

In morning after waking

34

Atonic and akinetic--Are they able to break their fall by putting out their hand?

No--leads to injury to face, head, and shoulder

35

What seizure: sudden, brief contractures of muscle or group of muscles

Myoclonic

36

Myoclonic are ____ episodes and may or may not be ___ and ___

Seizure episodes; may or may not be symmetric and LOC

37

What is a rare disorder that happens between 6-8 months of life?

Infantile spasms

38

Who is infantile spasms common in?

Boys

39

What happens in infantile spasms?

Numerous seizures during the day w/o drowsiness or sleep

40

Infantile spams: poor outlook on ____

Normal intelligence

41

Can an infant with infantile spasms sit? stand?

Sit-yes
Stand-no

42

Infantile spams: suded dropping forward of _____ with ___ flexed forward and ___drawn up

Sudden dropping forward of HEAD AND NECK with TRUNK flexed and KNEES drawn uo

43

Infantile spams: Flexion of what?

Neck trunk, or legs

44

Who gets phenytoin?

Partial or tonic clonic seizures

45

Who gets carbamazepine?

Partial or secondary generalized

46

Who gets valproic acid?

All types of seizures

47

What can be added to IV diazepam/lorazepam to control seizures/status epilepticus

Fosphenytonic sodium

48

Who gets ethosuximide?

Absence, myoclonic

49

Treatment of status elepticus at home? Whats good about this?

Rectal diazepam (prefilled rectal gel syringe); no resp. depression when used as recommended

50

What is treatment of status epilepticus at the hospital?

IV diazepam or lorazepam is DOC

*lorazapem may now be the best---longer duration of action and less resp. depression in children 2+

51

What is treatment of infantile spasms?

ACTH-gel form
*injection--parents can be taught to give this at home

52

What is the first action of seizures?

AIRWAY

53

How should we place person to maintain an open airway?

SIDE-LYING position to maintain open airway and prevent aspiration of secretions

54

EEGs are done to document abnormal activity. What are some guidelines to instruct the patient about this?

1. No caffeine before EEG b/c it can alter results
2. No analgesics
3. Normal foods can be eaten
4. Wash hair--remove oils that permit adherence of electrodes

55

Why do we check the serum levels in seizure patients?

To check for med compliance

56

T/F: Anyone can have febrile seizures and outgrow them

True

57

Nursing actions. What do we do if a seizure starts on our watch?

1. Immediately look watch and note time
2. Protect child from hurting themselves
3. Begin oxygen
4. Call for help
5. Note duration
6. Look for objective facts (deviation of eyes, what portion of body affected, type of movement)

58

What is a Ketogenic diet?

High fat
Low carb
Adequate protein

59

What is the shift when on a Ketogenic diet?

Body shifts from using glucose as energy source and using fat instead

60

T/F: Ketogenic diet is a rigorous diet

Yes, but it works!!

61

What kind of brain therapy is used to help treat seizures?

Vagus Nerve Stimulation

62

What is VNS?

Implantable device that reduces seizures in individuals who have not had effective control with drug therapy

63

How does VNS work?

SQ implantation in chest and electrodes are tunneled underneath skin to deliver electrical impulses to vagus nerve

Pt./caregiver can activate the device using a magnet on the onset of seizure

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