Flashcards in T3 - Seizures in Children (Josh) Deck (38)
Most seizures happen when?
first years of life
Seizure results from what/
overly active and hypersensitive neurons in brain that trigger electrical discharges
Categories of seizures:
Unclassified (ex: neonatal)
Examples of General Seizures:
Tonic-Clonic (Grand Mal)
Abseence (Petite Mal)
What is the Tonic and the Clonic in Tonic-Clonic?
Tonic = stiffening of body
Clonic = clonic muscle actiivty
-- involves recurrent and continuous generalized seizure activity with dangers of cardiac arrest and brain damage.
-- refers to rare disorder seen in the first few months of life that is characterized by flexion of the neck ,trunk or legs.
Examples of Partial Seizures
-- characterized by maintenance of consciousness . They may also include a focal motor compartment- abnormal movement of leg, sensory component- smell , sound, taste and autonomic component- sweating, or psychic component -deja vu or anger.
Simple partial seizures-
-- begin as simple and progress to unconsciousness. The child may stop whatever she’s doing and engage in purposeless movement- lip smacking or wandering.
Name the seizure:
Staring, eyes roll upward, change in LOC
Teacher may think student isn't paying attention in class
Absence (petit mal)
Name the seizure:
alteration of consciousness and may include lip smacking, or repetitive motion (picking, pulling)
Complex Partial Seizure
Phases of a Grand Mal
First phase of Grand Mal
Aura Phase (Early Seizure Phase)
the child may see, hear, smell or taste something unusual.
This phase may not occur in some children.
Second phase of Grand Mal
Tonic Phase (Stiffening Phase)
In this phase the child may experience a change in color, lose consciousness or become very stiff and rigid.
you may notice arching of the back, and extending of arms and legs. the child may fall if standing. the child may give a high pitched, shrill cry or snap his/her jaw shut, sometimes biting the tongue.
(Do not put anything in the child’s mouth).
Third phase of Grand Mal
Clonic Phase (Jerking phase)
Child may have rapid jerking movements on both sides of his/her body, tightening (flexing).
Breathing may be fast and loud with increased or decreased heart rate. The child may clench fists and teeth, and drip his/her head backwards. You may notice sweating and drooling.
This phase may last 2-5 minutes.
Fourth phase of Grand Mal
Postictal Phase (After Seizure Phase)
In this phase the child will slowly regain consciousness after several minutes, relaxing his/her muscles.
The child may complain of tiredness, muscle aching, or headache. He/she may seem confused, or may sleep.
(you should be able to arouse the child.)
What typically happens w/ a tonic-clonic?
How many phases are there w/ Grand Mal (Tonic Clonic)?
- Aura Phase
- Tonic Phase
- Clonic Phase
- Postictal Phase
watch the vids in the ppt
Types of labs for seizures
EEG will document abnormal activity
CBC Blood chemistry to identify underlying disorder such as metabolic disturbances.
Serum medication levels to monitor therapeutic levels of meds
Nursing management of Seizure Disorders:
Assess the child and obtain a thorough history
Administer prescribed meds
Document all seizure activity
Help prevent seizures
Promote optimal growth and development and minimize child’s anxiety
Prepare the family for alternatives treatments when necessary such as surgery and vagus nerve stimulator.
Assess for safety and provide interventions as needed per patient seizure plan such as meds , oxygen and suction
Provide emergency interventions such as CPR
What should we do while we're holding the patient during seizure?
time it (look at watch)
protect child from hurting self
Call for help
Objective facts (deviation of eyes, what portion of body, types of mvmt)
Should we restrain child?
Don’t try and restrain a seizing child, just keep him safe and away from harm.
Should we put a tongue blade to protect from biting tongue?
Don’t put anything in his or her mouth, this is unnecessary and can cut the mouth, injure a tooth, cause vomiting, or result in a serious bite of your finger.
Can they actually swallow tongue in seizure?
T/F: Most seizures are dangerous.
most are harmless
T/F: we should hold tightly and hinder patient during seizure.
don't hinder patient movement during seizure
Should we let the child sleep after the seizure.
Yes, if they want to
- the brain is temporarily exhausted and there is no point in trying to keep the child awake