N120 seizure complications/medications
a tonic clonic seizure should be
timed if more than five minutes or followed by another seizure seek emergency help
Vagal Nerve Stimulator is used for epilepsy when
when surgery not an option
Status Epilepticus is a
A state of continuous seizure activity or a condition when seizures recur in rapid succession without return to consciousness between seizures
Generalized tonic-clonic and focal seizures medication includes
Dilantin (phenytoin) Tegretol (carbamazepine) phenobarbital divalproex Mysoline (primidone)
side effects of Status Epilepticus treatment
Diplopia, drowsiness, ataxia, mental slowness Noncompliance can be a problem
The mother whose child is generally alert and participates well in classroom activities is concerned that the teacher now reported that the child has frequent periods during the day when he appears to be staring off into space. The nurses should suspect that the child has which problem? School phobia Absence seizures Behavioral problem Attention deficit/hyperactivity syndrome
Absence seizures
status epilepticus includes
Any seizure lasting longer than 5 minutes is A neurological emergency During repeated seizures, the brain uses more energy than can be supplied Permanent brain damage can result
Dilantin (phenytoin)
Can take with food if it causes stomach upset Take with full (8 oz) glass of water, carbs (no protein) Do not take with antacids (decreased absorption) Take at same time every day for stable blood levels Do not stop abruptly May cause swelling and bleeding of gums (gingival hyperplasia) Can increase blood glucose Can weaken bones (take Vit. D supplement) Can harm unborn baby Can decrease effectiveness of hormonal birth control Periodic checks of blood levels and LFTs If missed dose take when you remember. Skip it of you don't remember until the next day. Limit alcohol
A client begins to experience a tonic-clonic seizure. Which actions should the nurse take to ensure patient safety? (SATA) Restrict the patient's movements Turn the supine patient to the side Open the unconscious patient's airway Gently guide the standing patient to the floor Place a padded tongue blade into the patient's mouth Loosen any restrictive clothing that the patient is wearing
Gently guide the standing patient to the floor Turn the supine patient to the side Loosen any restrictive clothing that the patient is wearing Open the unconscious patient's airway
The RN is reviewing a plan of care developed by a new nurse for a child who is being admitted to the pediatric unit with a diagnosis of seizures. The RN determines that the new nurse needs further teaching and should revise the plan of care if which incorrect intervention is documented? Maintain the bed in the low position Immobilize the child if a seizure occurs Place padding on the side rails of the bed Place the child in a side lying lateral position post-seizure
Immobilize the child if a seizure occurs
Psychosocial Issues complication include
Ineffective coping methods d/t problems related to having a seizure disorder Increased incidence of depression Epilepsy diagnosis still carries a social stigma Discrimination in employment and educational opportunities Transportation issues from legal sanctions against driving
The nurse is caring for a hospitalized seizure patient who is having a prescribed dosage of clonazepam adjusted. Because of the adjustment in the medication administration, which priority safety activity should the nurse plan to implement? Weigh the patient daily Assess for ecchymoses Institute seizure precautions Monitor blood glucose levels
Institute seizure precautions
Nursing Management for Seizures includes
Maintain a patent airway Protect the patient's head (put on a pillow) Turn the patient to their side Loosen constrictive clothing Ease patient to floor, if seated Do NOT restrain the patient Do NOT place any objects in the patient's mouth After seizure, reposition patient to open airway, suction, and apply O2 if needed Apply padded side rails
When a client is prescribed seizure precautions, which interventions should the nurse include in the plan of care? (SATA) Have suction equipment readily available Keep all the lights on in the room at night Keep a padded tongue blade at the bedside Assist the client to ambulate in the hallway Monitor the client closely while showering Lock the client's bed in the lowest position
Monitor the client closely while showering Lock the client's bed in the lowest position
A patient begins to experience seizure activity while in bed. The nurse should provide which intervention to prevent aspiration? Raise the head of the bed Loosen restrictive clothing Remove the pillow and raise the padded side rails Position the patient on the side
Position the patient on the side
The nurse prepares for the admission of the child with a diagnosis of tonic-clonic seizures and plans to place which items at the bedside? A tracheotomy set and oxygen Suction apparatus and oxygen An endotracheal tube and an airway An emergency cart and laryngoscope
Suction apparatus and oxygen
Vagal Nerve Stimulator is a
Surgically implanted electrode in the neck programmed to deliver electrical impulse to the vagus nerve Patient activated with a magnet when patient believes seizure is imminent Benefit seen within 24 months
The nurse observes a client during a seizure and notes that the client's entire body became rigid, and the muscles in all four extremities alternated between relaxation and contraction. What type of seizure should the nurse document? Partial seizure Absence seizure Tonic-clonic seizure Complex partial seizure
Tonic-clonic seizure
Absence and Myoclonic Seizures medication includes
Zarontin (ethosuximide) divalproex Klonopin (clonazepam)
Only a small percentage of patient's with seizure disorders have
abnormal EEG the 1st time it is done Repeated or continuous EEG may need to be done
Most useful diagnostic tool for epilepsy is
an accurate, comprehensive description of seizures and the patient's health history
1/3 of epilepsy patients require
combination drug therapy (2 or more drugs from different classes)
Most seizures do not require
emergency medical care Self-limiting with limited bodily injury
there is No cure available for
epilepsy
other medications used for seizure include
gabapentin topiramate Lamictal (lamotrigine) Gabitril (tiagabine) Keppra (levetiracetam) Zonegran (zonisamide) Lyrica (pregabalin)
the Therapeutic range for each medication for epilepsy is
he serum level above which most patients experience toxic side effects and below which most continue to have seizures
if you see someone having a tonic clonic seizure try to
lay the person on the floor and gently turn him to his side
Status epilepticus and 1st time seizure should seek
medical care immediately
Convulsive Status Epilepticus (CSE) is the
most dangerous type Can cause fatal ventilator insufficiency, hypoxemia, dysrhythmias, hyperthermia, and acidosis
during a tonic clonic seizure after putting the patient on the floor
move objects out of the way to prevent injury place something soft under the head remove objects on the head or around the neck
Most seizure meds have long half life so
patients can take them once or twice per day Patients must be weaned off meds slowly, or seizures can develop
the goal in treating epilepsy is to
prevent seizures with minimal toxic side effects from drug therapy
Status Epilepticus drug therapy requires
rapid acting IV anti-seizure medication Ativan (lorazepam) or Valium (diazepam) Short-acting is followed with long-acting drugs (phenytoin, phenobarbital)
Anterior temporal lobe resection is a
removal of the epileptic focus 70 - 80% of patients become seizure free 10 - 20% see a marked reduction in seizure activity
with epilepsy CBC, BMP, studies of liver and kidney function, and UA are used to
rule out metabolic disorders
with epelepsy a CT scan or MRI are used to
rule out structural lesion
Subclinical Seizures is an complication that includes
sedated patient seizes with no movement d/t sedation Severe injury and death by trauma can occur
if a patient is having a tonic clonic seizure do not
stop their movements place objects in the mouth
