Test 3 Seizures vs. Epilepsy (CNS, Brain) Flashcards
(25 cards)
_____ are abrupt, abnormal, excessive and uncontrolled electical discharge of neurons within the brain that may cause alterations in the level of consciousness and/or changes in motor and sensory ability and/or behavior.
Seizures
_____ is the term used to define a syndrome characterized by chronic recurring abnormal brain electrical activity.
Epilepsy
Seizure: \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_\_ \_\_\_\_\_\_
Epilepsy:
_____ or ______
Seizures on ____ ____ (___-term)
Seizure:
- Generalized
- Partial
- Unclassified
- Secondary seizures
Epilepsy:
- Primary or idiopathic
- Seizures on regular basis (long-term)
Which type of Generalized seizure?
Both cerebral hemispheres 2 -5 minutes Loss of consciousness Incontinent Biting of tongue Postictal period with fatigue, lethargy, confusion
Tonic-clonic
Which type of Generalized seizure?
Abrupt increase in muscle tone
Loss of consciousness (LOC)
Lasts 30 seconds to several minutes
A loss of consciousness occurs
Tonic seizure
Which type of Generalized seizure?
Muscle contraction and relaxation.
Lasts several minutes
Clonic seizure
Which type of Generalized seizure?
- Most common in children
- Loss of consciousness lasting a few seconds
- Associated with blank stare
- May also include unconscious, involuntary behavior associated with eye fluttering, smacking lips, and picking at clothes called automatism.
Absence seizures
Which type of Generalized seizure?
Brief jerking or stiffening of extremities
(may symmetrical or asymmetrical)
Lasts for seconds
Myoclonic seizure
Which type of Generalized seizure?
-Sudden loss of muscle tone
- Followed by period of confusion
- Loss of muscle tone frequently results in falling
Atonic (or akinetic) seizure
What are the 2 types of partial or focal/local seizures?
Complex partial seizure
Simple partial seizure
Partial or focal/local seizure:
What are characteristics of complex partial seizures?
\_\_\_ \_\_\_ \_\_\_\_ (\_\_\_\_ minutes) \_\_\_\_ can occur \_\_\_\_\_\_ post seizure Also called \_\_\_\_ or \_\_\_ \_\_\_\_ seizures More common in \_\_\_\_ \_\_\_\_\_
Complex partial:
- LOC (Loss of consciousness) 1-3 minutes
- Automatisms can occur
- Amnesia post seizure
- Also called psychomotor or temporal lobe seizures
- More common in older adults
Partial or focal/local seizure:
What are characteristics of Simple partial seizures?
_____ _____
____ may occur
___ ____ movement
____ ____ (May know when it is coming on)
Can have ____ ____ such as changes in heart rate and abnormal flushing, unilateral abnormal extremity movements, pain or offensive smell.
Simple partial:
- Remains conscious
- Aura may occur
- One sided movement
- Unusual sensations (May know when it is coming on)
- Can have autonomic symptoms
What are the seizure risk factors?
Metabolic disorders Acute alcohol withdrawal Electrolyte disturbances Heart disease High fever Stroke Substance abuse
What are the seizure precautions?
Seizure Precautions:
Oxygen Suction equipment Airway IV access Side rails up No tongue blades
How do you take care of a patient during a seizure (patient safety)?
- *Depends on the type of seizure
- Protect the patients privacy and keep away from injury (remove furniture and hold head in lap if on floor)
- Do not force anything in mouth
- Side-lying position to keep airway clear
- Loosen restrictive clothing
- Do not attempt to restrain patient!!!
- Record when seizure began, ended, and observations.
- Call for help! (Especially, if airway conpromised)
What is a prolonged seizure that lasts more than 5 minutes or repeated seizures over course of 30 minutes — Medical emergency?
Status epilepticus
What causes Status epilepticus?
Causes:
- Withdrawal from drugs or alcohol
- Sudden withdrawal from antiepileptic -medications
- Head injury
- Cerebral edema
- Infection
- Fever
What is the nursing action for status epilepticus?
Status epilepticus (Nursing Action):
- Establish and maintain airway
- Provide oxygen
- Establish IV access
- IV push lorazepam, diazepam
- Rectal diazepam
- Loading dose of IV phenytoin
- ABGs
What is the Acute seizure management ?
Acute Seizure Management:
- Lorazepam (Ativan) –> Most commonly given IV for active seizures
- Diazepam (Valium) - Not first b/c has lots of side effects.
- Diastat
- IV phenytoin (Dilantin) or fosphenytoin (Cerebyx):
What are the nursing considerations for the drug therapy?
Drug Therapy Nursing Considerations:
- Therapeutic levels determined by blood tests
- Drug-drug/drug-food interactions
- Maintain therapeutic blood levels for maximal effectiveness
- Do not administer warfarin with phenytoin!!!
- Document and report side/adverse effects
- Medications should be taken same time everyday.
What medications should not be taken with phenytoin and why?
- Do not administer warfarin with phenytoin because phenytoin may decrease absorption and increase metabolis or oral anticoagulants.
- Oral contraceptive b/c phenytoin decreases their effectiveness
What are the surgical managements?
Surgical interventions include placement of a vagal nerve stimulator and excision of the portion of the brain causing the seizures for intractable seizures (anterior temporal labe resection or partial corpus callosotomy).
Surgical management:
What surgical intervention is used to treat refractory complex partial seizures?
Anterior temporal lobe resection
What surgical intervention interrupts the communication between the 2 cerebral hemispheres?
Partial corpus callosotomy
