Pearson - Seizure Disorders - Module
"Fever is known to be a trigger for seizures in children." High fever can cause seizures in otherwise healthy individuals. Fever is an independent risk factor; other risk factors do not need to be present. There may be a genetic component to seizure disorder; however, seizure disorder is not an inherited disorder. Seizures in children can be caused by a number of factors, including fever and being small for gestational age. The child's seizure is most likely the result of fever because fever was present at the time of the seizure.
A 4-year-old child presents with a high fever. The child's mother states, "My son began to seize. What caused this?" Which response by the nurse is correct? "Seizures are usually the result of an inherited disorder." "Fever is known to be a trigger for seizures in children." "Seizures in children are usually caused by a birth defect." "Fever does not cause seizures without other risk factors being present."
Maintaining a ketogenic diet The nurse needs to instruct the parents to maintain a ketogenic diet and to notify the healthcare provider if the child experiences constipation, which is a complication with this type of seizure. The parents do not need to restrict the child's fluid intake. The parents need to report a weight gain to the healthcare provider, not a weight loss. Urine ketones need to be monitored every week.
A nurse is caring for a 7-year-old child who was recently diagnosed with absence seizures. When providing discharge teaching to the parents, which clinical therapy should the nurse recommend be implemented at home? Maintaining a ketogenic diet Reporting weight loss in the child Monitoring urine ketones every month Restricting fluid intake
"The healthcare provider will make that determination, but long-term antiseizure medicine is not recommended for seizures caused by fever." The nurse will defer to the healthcare provider for prescribing information but can share that long-term antiseizure medication is not recommended for simple febrile seizures. Following the medical evaluation, the healthcare provider may suggest administrating antipyretics (e.g., Tylenol) at home when a fever appears because children with a history of febrile seizure are at risk for having another episode. A head CT and EEG are typically done to rule out pathologic origin of a seizure disorder that occurs in a child with a fever. A glucose test is not indicated because an alteration of the glucose level does not relate to febrile seizures in children.
A parent brought their 2-year-old child to the emergency department following a seizure due to a high fever. They ask the nurse, "Will my child need to take medicine to prevent this from happening again?" Which response from the nurse correctly answers this question? "The healthcare provider will order a glucose test before making that decision." "The next time your daughter has a fever, do not give her acetaminophen (Tylenol)." "The healthcare provider will most likely prescribe a medication that your daughter will need to take for the rest of her life." "The healthcare provider will make that determination, but long-term antiseizure medicine is not recommended for seizures caused by fever."
"It can take trying more than one medication to find the one that is right for you." For patients with recurrent seizures that are not controlled by the initial medication or for patients with life-affecting side effects, discuss the possibility of replacing the medication with another medication. The patient should discuss how they are feeling and whether they wish to discontinue the medication with the healthcare provider. It is likely that leaving the condition untreated will result in another seizure. Although surgery can be a viable treatment option, the patient should not be threatened with the possibility to gain compliance.
A patient has stopped taking their antiseizure medication and tells the nurse, "I stopped taking my medication because it makes me feel funny." Which statement by the nurse is appropriate? "It can take trying more than one medication to find the one that is right for you." "That is fine. You may not have any more seizures." "If you don't take your medication, the healthcare provider may want to perform surgery." "I think you should try something else."
Past seizure activity Specific to seizure assessment, it is important to assess past seizure activity to identify possible triggers, changes in seizures, and effectiveness of antiseizure medication. Menopause status is important data but is not related to seizure disorder. Surgical history is important but is not specific to seizure status. Occupational history is certainly important and may be important with regard to safety or precipitating factors, but past seizure activity is more specific to the assessment of seizure disorder.
A patient is being admitted for recurrent seizure activity. What assessment data is most important for the nurse to obtain? Past seizure activity Occupational history Surgical history Menopause status
Moving the patient into a side-lying position The priority action is to ensure adequate airway clearance and oxygenation. Moving a patient to a side-lying position, as shown in the image below, will promote oxygenation. No medication should be given orally during a seizure, but it may be administered intravenously. Nothing should ever be forced into the mouth during a seizure; this could cause broken teeth, which could be aspirated. The patient should not be held down during a seizure; this could cause injury.
A patient is having a seizure. Which priority action should the nurse take? Administering oral antiepileptic medication immediately Moving the patient into a side-lying position Holding the patient's arms and chest down Placing an oral airway between the teeth
"A section of the brain tissue identified as the source of the seizure initiation is removed." Three main types of surgery are used in the treatment of seizure disorders. The most common type is resection, in which the section of brain tissue identified to be the source of seizure initiation is removed. A transection interrupts the nerve pathways by which the impulses are transmitted. A vagus nerve stimulator can be placed in the chest. A craniotomy will be used to open the skull to access the brain, but that in itself is not a procedure for the treatment of seizures.
A patient scheduled for a resection for intractable seizures asks the nurse, "What will they do?" How should the nurse respond? "A section of the brain tissue identified as the source of the seizure initiation is removed." "The procedure interrupts nerve pathways by which the seizure impulses are transmitted." "It is a procedure that places a vagus nerve stimulator in the chest." "The skull will be opened to allow pressure to be reduced."
"Your mother most likely had a seizure." Older adults usually present with a blank stare, brief unresponsiveness, language difficulties, and confusion. The postictal phase is longer in older adults, sometimes lasting up to 2 weeks. Seizure disorders are treated with antiseizure medication. Antihypertensive medication is prescribed for high blood pressure. Seizures in older adults can jeopardize independence, including the ability and approval to drive a car.
A patient was brought to the emergency department after an episode explained by their son as a blank-stare lack of response. The patient eventually had difficulty speaking and was confused. Which statement by the nurse is most accurate? "This will resolve quickly." "Don't worry, your mom's independence will not be affected." "Your mother most likely had a seizure." "Seizures like these can be controlled with antihypertensive medication."
Meditation Relaxation techniques, such as meditation (shown in the image below), can help to reduce stress and may help to reduce seizures. Flashing lights would not be indicated as they are a trigger for seizures. Self-care includes balancing rest and activity, not going to extremes on either end of the spectrum. Herbal preparations such as St. John's wort have been found to decrease the effectiveness of antiseizure medications.
A patient who is newly diagnosed with a seizure disorder asks the nurse, "What lifestyle alterations can I make to reduce stress and help prevent seizure activity?" Which suggestion should the nurse include? St. John's wort Meditation Extreme sports Flashing-light therapy
Work with administrators to develop an individualized care plan to include medications and precautions. The family should be encouraged to work with school administrators to develop an individualized healthcare plan, so the child can receive needed medications during school hours and to assure that staff is trained in how to handle a seizure. There is no need to isolate a child with epilepsy. The child can proceed with a regular education at school.
A school-age child with epilepsy is transferring to a new school. Which action should the nurse suggest the parents implement? Work with administrators to develop an individualized care plan to include medications and precautions. The parents should request that the child be separated from other children to prevent seizures. The child should be given home schooling. There are no special considerations.
"The possible adverse effects of the medication on the fetus can be prevented with vitamins." Pregnant women can safely carry a pregnancy and prevent seizure with medication with close monitoring of the woman and fetus. Adverse effects of antiseizure medication on the fetus can be prevented with specific vitamins like folic acid and vitamin D. Many of the defects can be prevented by increasing the woman's dosage of folic acid to 4 mg/day before and during pregnancy. In addition, risk of hemorrhagic disease in the newborn due to exposure to antiseizure medications can be reduced by increasing the pregnant woman's intake of vitamin D during pregnancy and administering vitamin K to the neonate. Medication should not be stopped but may be adjusted throughout pregnancy as blood volumes change.
A young woman who is prescribed antiseizure medication plans to get pregnant. Which response by the nurse is accurate? "There is too great a risk to the baby to take medication during pregnancy." "The possible adverse effects of the medication on the fetus can be prevented with vitamins." "You will need to stop taking your antiseizure medication throughout the pregnancy." "You will stay on your same dose of medication throughout the pregnancy."
Small for gestational age Being small for gestational age is a risk factor for seizures in infants. Multiple sclerosis typically manifests later in life. An infant is not developed enough to display the signs of ADHD. Sciatica would not be easily diagnosed in an infant.
An infant is being evaluated after having a seizure. The nurse should assess the infant for which risk factor? Sciatica Attention-deficit/hyperacticity disorder (ADHD) Small for gestational age Multiple sclerosis
"Your son may be able to recognize certain sensory or experiential seizure warning signs prior to a seizure." An aura may provide an early warning sign, especially for partial seizures, and may manifest as any type of sensory disturbance, such as auditory, visual, or abdominal. When patients recognize the pattern of the aura, they may have time to avoid injury by getting to the floor. Football and soccer could place the patient at risk for head injuries, which could trigger further seizures. Herbal remedies have a tendency to increase or decrease the effectiveness of antiseizure activities. Although avoiding hypoglycemia by eating properly is an important dietary consideration, there are no direct recommendations for a special diet, such as a vegan diet.
During a teenager's visit to the doctor for a physical examination to play school sports, the mother asks if there is anything they can do to prevent a seizure. Which statement by the nurse is an action the patient can use to help prevent seizures? "Your son could try to incorporate a vegan diet." "Continuing to play football and soccer will help your son stay physically active." "Your son may be able to recognize certain sensory or experiential seizure warning signs prior to a seizure." "You could look into visiting an herbalist if you are interested in trying a more naturalistic path for treatment."
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The patient is sleepy but arousable. The patient is experiencing the postictal period following a seizure. Assessment findings that the nurse can expect in this phase include the patient being sleepy but arousable. During the tonic phase of a seizure, the patient will experience unconsciousness, continuous muscular contractions, and cyanosis.
The nurse is caring for a patient immediately after a seizure. Which assessment finding should the nurse expect? The patient is cyanotic. The patient is unconscious. The patient is sleepy but arousable. The patient is experiencing muscular contractions.
Electroencephalogram (EEG) An EEG measures the electrical impulses of the brain's cells and is usually ordered at the first sign of seizure activity. The ECG is a reflection of the electrical impulses of the conduction system of the heart. An EMG measures the electrical activity of the skeletal muscle. An ESR determines the rate at which red blood cells settle in unclotted blood and can be elevated in the presence of an inflammatory process.
The nurse is caring for a patient with a suspected seizure disorder. Which diagnostic test should the nurse anticipate to be ordered? Erythrocyte sedimentation rate (ESR) Electroencephalogram (EEG) Electrocardiogram (ECG) Electromyogram (EMG)
