seizers

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1. Time the seizure. 2. Restrain the child. 3. Stay with the child. 4. Place the child in a prone position. 5. Move furniture away from the child. 6. Insert a padded tongue blade in the child's mouth.

1. Time the seizure. 3. Stay with the child. 5. Move furniture away from the child.

A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG). Which of the following should be included in the teaching?A. "Decaffeinated beverages should be offered on the morning of the procedure."B. "Do not wash your child's hair the night before the procedure."C. "Withhold all foods the morning of the procedure."D. "Give your child an analgesic the night before the procedure.

A. "Decaffeinated beverages should be offered on the morning of the procedure."

A patient is taking Phenytoin for treatment of seizures. Which statement by the patient requires you to re-educate the patient about this medication? A. "Every morning I take this medication with a full glass of milk with my breakfast." B. "I know it is important to have my drug levels checked regularly." C. "I will report a skin rash immediately to my doctor." D. "This medication can lower my body's ability to clot and fight infection."

A. "Every morning I take this medication with a full glass of milk with my breakfast."

You're assessing a patient who recently experienced a focal type seizure (partial seizure). As the nurse, you know that which statement by the patient indicates the patient may have experienced a focal impaired awareness (complex partial) seizure? A. "My friend reported that during the seizure I was staring off and rubbing my hands together, but I don't remember doing this." B. "I remember having vision changes, but it didn't last long." C. "I woke up on the floor with my mouth bleeding." D. "After the seizure I was very sleepy, and I had a headache for several hours."

A. "My friend reported that during the seizure I was staring off and rubbing my hands together, but I don't remember doing this."

You're assessing your patient load for the patients who are at MOST risk for seizures. Select all the term-30patients below that are at risk: A. A 32-year-old with a blood glucose of 20 mg/dL. B. A 63-year-old whose CT scan shows an ischemic stroke. C. A 72-year-old who is post opt day 5 from open heart surgery. D. A 16-year-old with bacterial meningitis. E. A 58-year-old experiencing ETOH withdrawal.

A. A 32-year-old with a blood term-30glucose of 20 mg/dL. B. A 63-year-old whose CT scan shows an ischemic stroke. D. A 16-year-old with bacterial meningitis. term-30E. A 58-year-old experiencing ETOH withdrawal

A nurse is teaching a group of parents about the risk factors for seizures. Which of the following should be included in the teaching? (Select all that apply.)A. Febrile episodesB. HypoglycemiaC. Sodium imbalancesD. Low serum lead levelsE. Presence of diphtheria

A. Febrile episodesB. HypoglycemiaC. Sodium imbalances

A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect? (Select all that apply.)A. Loss of consciousnessB. Appearance of daydreamingC. Dropping held objectsD. Falling to the floorE. Having a piercing cry

A. Loss of consciousnessB. Appearance of daydreamingC. Dropping held objects

You have a patient who has a brain tumor and is at risk for seizures. In the patient's plan of care you incorporate seizure precautions. Select below all the proper steps to take in initiating seizure precautions: A. Oxygen and suction at bedside B. Bed in highest position C. Remove all pillows from the patient's head D. Have restraints on stand-by E. Padded bed rails F. Remove restrictive objects or clothing from patient's body G. IV access

A. Oxygen and suction at bedside E. Padded bed rails F. Remove restrictive objects or clothing from patient's body G. IV access

A patient who is having a tonic-clonic seizure is prescribed Phenobarbital. During administration of this drug, it is important the nurse monitors for: A. Respiratory depression B. Hypertension C. Disseminated intravascular clotting D. Hypotension E. Fever

A. Respiratory depression D. Hypotension

A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following should be included in the discussion? (Select all that apply.)A. Vagal nerve stimulatorB. Additional anti-epileptic medicationsC. Corpus callosotomy D. Focal resection E. Radiation therapy

A. Vagal nerve stimulatorB. Additional anti-epileptic medicationsC. Corpus callosotomy D. Focal resection

. You're developing discharge instructions to the parents of a child who experiences atonic seizures. What information below is important to include in the teaching? A. "This type of seizure is hard to detect because the child may appear like he or she is daydreaming." B. "Be sure your child wears a helmet daily." C. "It is common for the child to feel extremely tired after experiencing this type of seizure." D. "Avoid high fat and low carbohydrate diets."

B. "Be sure your child wears a helmet daily."

You're educating a 25-year-old female about possible triggers for seizures. Which statement requires you to re-educate the patient about the triggers? A. "I'm at risk for seizure activity during my menstrual cycle." B. "I will limit my alcohol intake to 2 glasses of wine per day." C. "It's important I get plenty of sleep." D. "I will be sure to stay hydrated, especially during hot weather."

B. "I will limit my alcohol intake to 2 glasses of wine per day."

You're patient is scheduled for an EEG (electroencephalogram). As the nurse you will: A. Keep the patient nothing by mouth. B. Hold seizure medications until after the test. C. Allow the patient to have coffee, milk, and juice only. D. Wash the patient's hair prior to the test. E. Administer a sedative prior to the test.

B. Hold seizure medications until after the test. D. Wash the patient's hair prior to the test.

A patient with a history of epilepsy is taking Phenytoin. The patient's morning labs are back, and the patient's Phenytoin level is 7 mcg/mL. Based on this finding, the nurse will? A. Assess the patient for a rash B. Initiate seizure precautions C. Hold the next dose of Phenytoin D. Continue to monitor the patient

B. Initiate seizure precautions A normal Phenytoin level is 10 to 20 mcg/mL. The patient's level is low; therefore, the patient is at risk for seizures

Neurons in the brain are tasked with handling and transmitting information. There are different types of neurons, such as excitatory and inhibitory. Excitatory neurons release the neurotransmitter _____________, while inhibitory neurons release the neurotransmitter ________________. A. GABA, glutamate B. Norepinephrine, GABA C. Glutamate, GABA D. Dopamine, glutamate

C. Glutamate, GABA Excitatory neurons release glutamate and inhibitory neurons release GABA.

An 8-year-old child, who is not responding to anti-seizure medications, is prescribed to start a ketogenic diet. This diet will include: A. High carbohydrates and high fat B. Low fat, high salt, and high carbohydrates C. High fat and low carbohydrates D. High glucose, high fat, and low carbohydrates

C. High fat and low carbohydrates

. Keeping the previous question in mind, the patient is now experiencing characteristics of a tonic-clonic seizure. The seizure started at 1402 and it is now 1408, and the patient is still experiencing a seizure. The nurse should? A. Continue to monitor the patient B. Suction the patient C. Initiate the emergency response system D. Restrain the patient to prevent further injur

C. Initiate the emergency response system

Your patient has a history of epilepsy. While helping the patient to the restroom, the patient reports having this feeling of déjà vu and seeing spots in their visual field. Your next nursing action is to? A. Continue assisting the patient to the restroom and let them sit down. B. Initiate the emergency response system. C. Lay the patient down on their side with a pillow underneath the head. D. Assess the patient's medication history.

C. Lay the patient down on their side with a pillow underneath the head.

. Your patient has entered the post ictus stage for seizures. The patient's seizure presented with an aura followed by body stiffening and then recurrent jerking. The patient had incontinence and bleeding in the mouth from injury to the tongue. What is an expected finding in this stage based on the type of seizure this patient experienced? A. Crying and anxiety B. Immediate return to baseline behavior C. Sleepy, headache, and soreness D. Unconsciousness

C. Sleepy, headache, and soreness

1. You are paged by the nurse to come to the bedside of a patient with known seizure disorder who is actively seizing. On arrival to the bedside, you note that the patient is having tonic-clonic movements of all extremities, upward eye deviation, and frothing at the mouth. The next step in the assessment/management of this patient is to A. Ask the nurse how long the patient has been seizing B. Wait for your senior resident to come and assist you C. Have the nurse give lorazepam through the IV D. Suction and secure the airway E. Obtain a fingerstick blood glucose

D. Suction and secure the airway

True or False: A patient who is experiencing a tonic-clonic seizure is experiencing a focal (partial) seizure.

FALSE: A patient who is experiencing a tonic-clonic seizure is experiencing a GENERALIZED seizure. This type of seizure affects both sides of the brain.

*Questions to be asking yourself during the seizure

Note the time it started and time it stopped (VERY IMPORTANT: if greater than 5 minutes or another seizure happens...THINK: status epilepticus and activate the emergency system response team.

______ = only part of the brain is affected; ______ = the entire brain is affected.

Partial seizure; general seizure

What to do when your patient has a seizure?

Protect patient if they are standing-up or sitting down by: 1) gently lying the patient down and turning them onto their side 2) DO NOT restrain patient or try to hold the patient down 3) Protect their head and extremities (pillow and bed pads will help with this) 4) DO NOT put anything in the patient's mouth 5) Remove anything that can impede breathing or break

Myoclonic:

Quick duration of jerking of the muscles Patient usually aware and conscious (this is what makes it different from a clonic seizure) Very short....few seconds

What are seizures

Seizures occur when abnormal electrical signals are being rapidly fired for neurons in the brain.

Education to patient about factors that can trigger a seizure:

Stress Trauma to the head Overexertion Period, pregnancy (hormones) Sleep depravation Electrolyte and metabolic issues (hypoglycemia, dehydration, acidosis) Illness (high fever) VisualiZation disturbances (strobe lights, certain smells or sounds) Under medicated with seizure med (remind patient importance of taking and coming to office visits to get drug levels drawn) Recreational drugs ETOH use

Tonic-clonic seizures (stiffening of the body)

Tonic-clonic seizures should last about 1-3 minutes. If the seizure lasts MORE than 5 minutes, the patient needs medical treatment FAST to stop the seizure....this is known as status epilepticus. It is common for the child to feel extremely tired after experiencing this type of seizure."

atonic seizures (drop attacks)

WITHOUT MUSCLE TONE (may need helmet) sudden loss of muscle tone. The patient will go limp and fall, which when this happens the head is usually the first part of the body to hit the floor or an object nearby. It is important the child wears a helmet daily to protect their head from injury.

What can lead to seizure

alcohol,Hormone shifts (menstrual cycle, ovulation, pregnancy) sleep deprivation, and dehydration can lead to a seizure.

Nursing Interventions for Seizures

at bedside have suction and oxygen ready IV access (to given anti-seizure medication, if needed) padded side rails pillow under head (to protect head) bed in the lowest position remove objects that can cause injury (remove any restrictive clothing or items the patient may be wearing....eye glasses etc. ) Assess if your patient has a history of seizures in the pas

Epilepsy

chronic brain disorder characterized by recurrent seizure activity. like congenital brain defect, stroke, traumatic brain injury, long-lasting effects of an infection

Seizures can occur in anyone

due to a severe acute condition, such as a high fever, illness, hypoglycemia, acid-base imbalances like acidosis, alcohol withdraw, brain tumor

absence seizure (formerly called petit-mal)

form of seizure consisting of momentary clouding of consciousness and loss of awareness of surroundings. "This type of seizure is hard to detect because the child may appear like he or she is daydreaming." Hallmark is a staring like state

Clonic seizure

jerking....can be symmetrical or asymmetrical

: Nursing actions during a seizure

providing for privacy, loosening restrictive clothing, removing the pillow and raising padded side rails in the bed, and placing the client on 1 side with the head flexed forward, if possible, to allow the tongue to fall forward and facilitate drainage.

aura

sudden weird smell or taste, déjà vu feeling, feeling anxious like something bad is about to happen, altered vision (lights or spots in vision) or hearing (hallucination type sounds or increased ability to hear sounds), dizzy (different for every person), inability to spea

If the client is not in bed when seizure activity begins,

the nurse lowers the client to the floor, if possible; protects the head from injury; and moves furniture that may injure the client.

post ictus stage (after the seizure)(recovery phase)

the patient is expected to be sleepy (very tired), have soreness, and a headache. They usually can't remember what happened. The nurse should let the patient sleep. (hours to days)