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Lecture on Seizures and Status Epilepticus
Jun 30, 2024
Lecture on Seizures and Status Epilepticus
Introduction
Presenter
: Cathy from LevelUpRN
Topics
: Seizures, Status Epilepticus
Quiz
: 3 questions at the end
Resources
: LevelUpRN medical-surgical nursing flashcards
Seizures
Definition
: Uncontrolled electrical discharge of neurons in the brain
Epilepsy
: Diagnosed if a patient has two or more episodes of unprovoked seizures
Pathophysiology
:
Disease, injury, or unknown cause leads to hyper excitability and decreased inhibition of neuron activity
Risk Factors
:
Fever (common in children: febrile seizures)
Cerebral edema
Infection (e.g., meningitis)
Fluid and electrolyte imbalances (especially hyponatremia)
Drug or alcohol withdrawal
Triggers
:
Fatigue, stress, flashing lights, caffeine
Types of Seizures
Tonic-Clonic Seizure
(formerly grand mal)
Tonic Episode
: Stiffening of muscles, loss of consciousness
Clonic Episode
: 1-2 minutes of rhythmic jerking of extremities
Postictal Phase
: Confusion, sleepiness, possible agitation
Absence Seizure
Symptoms
: Loss of consciousness for a few seconds, resembles daydreaming
Other Symptoms
: Picking at clothes, lip smacking, eye fluttering
Myoclonic Seizure
Symptoms
: Brief jerking of extremities, usually no loss of consciousness
Atonic Seizure
Symptoms
: Loss of muscle tone, risk of falling
Diagnosis and Treatment
Diagnosis
: EEG (electroencephalogram)
Medications
: Antiepileptics/anticonvulsants (e.g., valproic acid, carbamazepine, phenytoin)
Details available in pharmacology playlist
Procedures
:
Vagal Nerve Stimulator
: Surgically implanted, sends electrical pulses to vagus nerve
Craniotomy
: Remove brain tissue responsible for seizures
Nursing Care During a Seizure
Actions
:
Lower patient to the floor or bed if standing or sitting
Turn patient to their side
Loosen restrictive clothing
Do not place anything in the mouth or restrain the patient
Note onset and duration of the seizure
Post-Seizure
:
Check vital signs and neurological status
Reorient the patient
Implement seizure precautions (e.g., pad side rails)
Identify possible triggers
Status Epilepticus
Definition
: Prolonged seizure (> 5 minutes) or failure to regain consciousness between seizures
Risk Factors
: CNS infection, head trauma, drug withdrawal/toxicity
Treatment
:
Antiepileptic agents (e.g., phenytoin)
Benzodiazepines (e.g., lorazepam)
Anesthetic agents (e.g., propofol)
Barbiturates (e.g., phenobarbital)
Nursing Care
:
Maintain patent airway
Administer oxygen as prescribed
Assist with intubation
Quiz Questions
Question
: What type of seizure is characterized by blank staring, eye fluttering, and picking at clothes?
Answer
: Absence seizure
Question
: What phase of a tonic-clonic seizure is characterized by confusion and sleepiness?
Answer
: Postictal phase
Question
: What life-threatening disorder is characterized by a prolonged seizure or failure to regain consciousness between seizures?
Answer
: Status epilepticus
Conclusion
Next Topic: Meningitis
Stay tuned for more videos from LevelUpRN
📄
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