Seizure

The nurse is providing care for a patient who is newly diagnosed with tonic-clonic seizures. The patient asks, "What type of testing should I expect?" How should the nurse respond? "A CT scan will help to rule out a brain tumor." "A blood culture will show if you have an infection in your brain." "An electrocardiogram will show the electrical activity in your brain." "An electromyogram will show if you have a tumor in your brain."

"A CT scan will help to rule out a brain tumor."

The nurse is caring for a patient who is newly diagnosed with tonic-clonic seizures. The healthcare provider has admitted the patient for diagnostic testing to rule out a brain tumor. The nurse should anticipate an order for which diagnostic test? Electrocardiogram (ECG) Blood cultures Electromyogram (EMG) Computerized tomography (CT) scan

Computerized tomography (CT) scan A CT scan would be ordered to identify abnormalities in the patient's brain. The nurse would not anticipate an order for blood cultures. Blood cultures are used to identify microorganisms in the blood and would not help diagnose a brain tumor. The nurse would not anticipate an order for an ECG. An ECG provides information about the electrical conduction in the heart and would not help to diagnose a brain tumor. Electromyography is used to measure skeletal muscle activity and would not be used to help diagnose a brain tumor. Following is a close-up of a CT scan of a brain.

Which comorbidity in children is associated with a seizure disorder? Hyperglycemia Attention-deficit/hyperactivity disorder (ADHD) Otitis media Hypertension

Attention-deficit/hyperactivity disorder (ADHD) Children who have a seizure disorder are at a higher risk for comorbid conditions, including ADHD. High blood pressure and high blood sugar, while problematic, are not conditions that are seen with children who have seizures. While a fever associated with otitis media might bring on a seizure, otitis media is not a typical comorbidity.

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. There are no special considerations. The child should be given home schooling. The parents should request that the child be separated from other children to prevent seizures.

Work with administrators to develop an individualized care plan to include medications and precautions.

A patient scheduled for a resection for intractable seizures asks the nurse, "What will they do?" How should the nurse respond? "The procedure interrupts nerve pathways by which the seizure impulses are transmitted." "The skull will be opened to allow pressure to be reduced." "It is a procedure that places a vagus nerve stimulator in the chest." "A section of the brain tissue identified as the source of the seizure initiation is removed."

"A section of the brain tissue identified as the source of the seizure initiation is removed."

The nurse is caring for an older woman being admitted for recurrent seizure activity. When conducting the health history, which question is most appropriate? "Have you had any recent surgery?" "What did you do for work?" "Have you ever had a seizure before?" "When did you start menopause?"

"Have you ever had a seizure before?" Physical assessment for patients with seizures includes: Complete physical and neurologic examination. Observation of the specific seizure activity. Level of consciousness. Vital signs. Neurologic checks.

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? "If you don't take your medication, the healthcare provider may want to perform surgery." "That is fine. You may not have any more seizures." "It can take trying more than one medication to find the one that is right for you." "I think you should try something else."

"It can take trying more than one medication to find the one that is right for you."

A patient who has a history of a recent stroke was brought to the emergency department by their son because they had a seizure earlier. The son asks the nurse, "Why did this happen?" Which response by the nurse is accurate? "Does your father have renal failure?" "It is not uncommon for a patient with a history of stroke to have a seizure." "Infection is often a cause of seizures in older adults." "Are there birth defects in your family?

"It is not uncommon for a patient with a history of stroke to have a seizure." Seizure disorder in older adults is often caused by: Stroke. Alzheimer disease. Heart disease. Tumors. Injuries from falls. However, approximately half of the seizures seen in older adults are cryptogenic, meaning that their cause cannot be identified.

The nurse is caring for a patient who experienced a seizure. The patient indicates that they were watching television when the seizure occurred and asks why they had the seizure. Which response from the nurse indicates a correct understanding of the cause of seizures? "Seizures are often caused by watching television." "Seizures are caused by having a fever." "Seizures are caused by low blood sugar." "Seizures are caused by abnormal electrical impulses in the brain."

"Seizures are caused by abnormal electrical impulses in the brain."

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." "You will stay on your same dose of medication throughout the 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."

"The possible adverse effects of the medication on the fetus can be prevented with vitamins." 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. Additional Learning Nursing considerations for antiseizure medications include: Monitor blood pressure, pulse, and respirations. Note evidence of central nervous system (CNS) side effects such as blurred vision, dimmed vision, slurred speech, nystagmus, confusion.Gingival hyperplasia may be noted in patients taking phenytoin. Recognize that patients on prolonged therapy may need a diet rich in vitamin D. Monitor serum calcium level as ordered; phenytoin can contribute to demineralization of bone. When administering antiseizure drugs intravenously, monitor closely for respiratory depression and cardiovascular collapse. Administer gabapentin 2 hours after antacids. Administer tiagabine HCl with food.

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." "Seizures like these can be controlled with antihypertensive medication." "Your mother most likely had a seizure."

"Your mother most likely had a seizure."

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." "Your son may be able to recognize certain sensory or experiential seizure warning signs prior to a seizure." "Continuing to play football and soccer will help your son stay physically active." "You could look into visiting an herbalist if you are interested in trying a more naturalistic path for treatment."

"Your son may be able to recognize certain sensory or experiential seizure warning signs prior to a seizure."

The nurse is preparing discharge teaching for a patient who was newly diagnosed with tonic-clonic seizures. Which instruction about driving safety should the nurse include? A patient can drive once they have met the state and local requirements for those with epilepsy. A patient can drive as soon as the antiepileptic medication is in the bloodstream. A patient cannot drive if taking medications for seizures. The patient will need to take the driving test again due to having had a seizure.

A patient can drive once they have met the state and local requirements for those with epilepsy. The patient would need to research state and local laws concerning driving after having a seizure. The patient would be able to drive again when the state and local requirements are met. Many states allow driving after being seizure free for at least 2 years. Taking the driving test again will not ensure that the patient will not have another seizure. The safety issue is related to the patient's seizures, rather than to being an unsafe driver. A sufficient blood level for the medication will not ensure that the patient will be seizure free.

A seizure that is not provoked by known stimuli is known as which of the​ following? A. Idiopathic B. Congenital C. Acquired D. Febrile

A. Idiopathic

Which of the following statements best describes a seizure​ threshold? A. The threshold is the limit beyond which the occurrence of a seizure is possible. B. Unless a seizure results in​ convulsions, it is considered to be below the threshold. C. The threshold is the length of time a seizure will last. D. When the threshold is​ exceeded, a seizure is considered to be generalized.

A. The threshold is the limit beyond which the occurrence of a seizure is possible.

The nurse provides teaching about phenytoin​ (Dilantin) to the mother of a​ school-age client with a seizure disorder. Which statement made by the mother indicates that teaching has been​ effective? A. ​"I will check his gums and increase visits to the​ dentist." B. ​"I will use a carbonated beverage to dilute his​ medication." C. ​"I will give his medicine on an empty stomach so he will absorb it​ better." D. ​"I will allow him to chew the​ tablet."

A. ​"I will check his gums and increase visits to the​ dentist."

The nurse observes a​ school-age client have an absence seizure. Which statement will the nurse likely include when documenting this​ seizure? A. ​"Sat very still and was unresponsive with a blank stare for 30​ seconds." B. ​"Repeatedly moved from the chair to the bed while touching the arms for a length of 2​ minutes." C. ​"Reported experiencing tingling sensations but denied loss of​ consciousness." D. ​"Became unconscious, and all four extremities were jerking uncontrollably for 2​ minutes."

A. ​"Sat very still and was unresponsive with a blank stare for 30​ seconds."

Which is a treatment for a child with a history of febrile seizures? No special treatment is required Antiseizure medication Glucose testing Antipyretics when fever occurs

Antipyretics when fever occurs Following the medical evaluation, the healthcare provider may suggest administering 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 glucose test is not indicated because an alteration of the glucose level does not relate to febrile seizures in children. Long-term antiseizure medication is not recommended for simple febrile seizures. To say that no special treatment is required is both incorrect and nontherapeutic.

Which dietary practice is important for the promotion of self-care for a patient with a seizure disorder? Increasing megavitamin doses Increasing consumption of oils/fats Avoiding alcohol Eating a gluten-free diet

Avoiding alcohol Alcohol is a general trigger for seizures. Ingested oil through the digestive system is digested and does not directly affect the nerves. Although avoiding hypoglycemia by eating properly is an important dietary consideration, there are no direct recommendations for megavitamin doses or a special diet, such as one that is gluten-free. Maintaining good self-care for individuals with known seizure disorders includes: Maintaining the therapeutic regimen. Avoiding alcohol. Eating properly. Balancing rest and activity.

The nurse identifies the diagnosis Risk for Injury as appropriate for a client with a seizure disorder. Based on this​ diagnosis, which nursing interventions are appropriate when this client experiences a​ seizure? Select all that apply. A. Insert a tongue blade into the​ client's mouth. B. Call for help. C. Stay with the client. D. Turn the client to a lateral​ position, if possible. E. Restrain the client.

B, C, D B. Call for help. C. Stay with the client. D. Turn the client to a lateral​ position, if possible.

Which of the following is characteristic of triggers for​ seizures? A. They are generalized. B. They are variable. C. They are internalized. D. They are externalized.

B. They are variable.

The nurse is planning discharge teaching for a child with epilepsy who has been prescribed phenytoin​ (Dilantin). The nurse should recommend a diet rich in which of the following to this​ client? A. Carbohydrates B. Vitamin D C. Fats D. Protein

B. Vitamin D

The nurse makes a visit to the home of an adolescent recently discharged from the hospital following treatment for a​ tonic-clonic seizure disorder. Which observations indicate that outcomes for care have been​ achieved? Select all that apply. A. The client is complaining of constipation. B. The client has bruises on both arms. C. The client is participating in the school basketball team. D. The client has not had a seizure for 1 month. E. The client is not driving.

C, D, E C. The client is participating in the school basketball team. D. The client has not had a seizure for 1 month. E. The client is not driving.

An older adult client is experiencing a​ tonic-clonic (grand​ mal) seizure exceeding 10 minutes in length. Which medication should the nurse prepare to administer to this​ client? A.Intramuscular injection of phenytoin B. Intramuscular injection of diazepam C. Intravenous diazepam slowly over several minutes D. Oral administration of gabapentin

C. Intravenous diazepam slowly over several minutes

The nurse is caring for a​ toddler-age client who starts to have a​ tonic-clonic (grand​ mal) seizure while in a crib in the hospital. The​ child's jaws are clamped shut. What is the most appropriate nursing​ action? A. Restrain the child to prevent injury. B. Prepare the suction equipment. C. Stay with the child to observe for complications. D. Place a tongue blade between the​ child's jaws.

C. Stay with the child to observe for complications.

A​ preschool-age client with myoclonic seizures has been following a ketogenic diet for the last 6 months to reduce seizure activity and is complaining of​ left-sided lower abdominal pain. Which complication of the ketogenic diet should the nurse suspect the client is​ experiencing? A. Urinary tract infection B. Appendicitis C. Bowel obstruction D. Kidney stone

D. Kidney stone

What type of seizure does not affect memory or awareness and occurs when abnormal electrical activity is contained to a limited area of the​ brain? A. Complex focal B. Generalized C. Absence D. Simple focal

D. Simple focal

Which condition is a seizure disorder associated with pregnancy? Eclampsia Stroke Preeclampsia Hypotension

Eclampsia

The nurse is caring for a patient with a suspected seizure disorder. Which diagnostic test should the nurse anticipate to be ordered? Electroencephalogram (EEG) Electromyogram (EMG) Electrocardiogram (ECG) Erythrocyte sedimentation rate (ESR)

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 child during a well visit. The parent expresses concern regarding the possibility of a seizure. Which condition should the nurse identify as a possible trigger for a seizure in a child? Fever Inherited disorder Increased bilirubin Genetic defect

Fever

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? Restricting fluid intake Reporting weight loss in the child Monitoring urine ketones every month Maintaining a ketogenic diet

Maintaining a ketogenic diet

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? Flashing-light therapy Meditation Extreme sports St. John's wort

Meditation

The nurse is caring for a patient who was transported to the emergency department after having a seizure. Which nursing actions are critical during the postictal period of seizure activity? Performing neurologic checks and suctioning every 15 minutes Monitoring vital signs, inserting an intravenous line, and performing cardiopulmonary resuscitation Ensuring safety and drawing blood for ordered tests Monitoring vital signs, performing neurological checks, and ensuring safety

Monitoring vital signs, performing neurological checks, and ensuring safety

A patient is having a seizure. Which priority action should the nurse take? Moving the patient into a side-lying position Placing an oral airway between the teeth Holding the patient's arms and chest down Administering oral antiepileptic medication immediately

Moving the patient into a side-lying position

A patient is being admitted for recurrent seizure activity. What assessment data is most important for the nurse to obtain? Occupational history Past seizure activity Menopause status Surgical history

Past seizure activity

The mother of a child who was recently diagnosed with epilepsy is overwhelmed with the idea of their child having a chronic illness. Which nursing intervention should help both the child and mother once they are at home? Finding out if the mother has relatives or friends with epilepsy Encouraging the mother not to share the child's condition with anyone other than healthcare providers Discouraging the mother from sharing their feelings with others Referring the patient and family to support groups and counseling services

Referring the patient and family to support groups and counseling services

An infant is being evaluated after having a seizure. The nurse should assess the infant for which risk factor? Multiple sclerosis Sciatica Attention-deficit/hyperactivity disorder (ADHD) Small for gestational age

Small for gestational age

The nurse is caring for a patient immediately after a seizure. Which assessment finding should the nurse expect? The patient is sleepy but arousable. The patient is cyanotic. The patient is experiencing muscular contractions. The patient is unconscious.

The patient is sleepy but arousable.