Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide

Epilepsy (Seizure Disorders) Seizures can be caused by anything from head injury to actual diseases, seizure disorders, and medications. Sometimes the cause is unknown. Some of the factors involved in the cause of seizures are electrolyte disturbances, hypoxia, street drugs and alcohol use, low blood sugar (hypoglycemia), and brain tumors. Seizures can come on suddenly and unexpectedly. Understand that families of patients experiencing a seizure can be quite alarmed if this is the first episode. The function of a nurse is to first protect the patient, calm the family, and ensure that an adequate assessment is made. Second the nurse will need to ensure adequate respiratory ventilation, give medications per protocol quickly, and always ensure full seizureprecautions. Seizure activity is over activity in the brain and central nervous system. The nerve cells in the brain experience a disruption causing them to discharge abnormal impulses. Stopping epileptic medications suddenly, genetics, fever, swelling in the brain (cerebral edema), toxics, and infection can all precipitate seizures. When they are due to epilepsy, they can be triggered by fatigue, physical activity, stressful situations, alcohol, and caffeine use. It is also important for epileptics to continue medications on a strict schedule. Stopping epileptic medications will cause the levels to drop and cause seizure activity. There are several different types of seizures that include grand mal seizures, or tonic-clonic, typical absence seizures, atypical absence seizures, simple partial seizures, complex partial seizures, myoclonic seizures, and akinetic seizures. All of these types involve some disturbance in the brain and central nervous system that cause patients to have a fixed gaze, lose control of bowels and bladder, jerk the extremities, drool, and have mental status and emotional changes. Most seizures have an “aura” that is a warning sign prior to the seizure occurring. It can be a strong feeling, ringing in the ears, dizziness, light flashes, or noises. Epileptics usually get to know this factor and are able to take action to prevent themselves from getting hurt. People that do not have epilepsy do not recognize this symptom and are unable to protect themselves frominjury. Example Susie has had grand-mal seizures since childhood. Prior to a seizure occurring, she experiences an aura consisting of blinking lights and a strong ringing in her ears. She stops whatever she is doing and lays down flat on the floor on her left side to prevent aspiration. She has also informed her coworkers of seizure precautions, her medications, and the name of her physician in case they need to contact emergency help. Signs and symptoms of grand mal (tonic-clonic) seizures: • Loss of consciousness • Involuntary muscle stiffening (clonic) • Jerking of extremities (tonic) • Tongue biting • Drooling • Incontinence • Blue color to skin (cyanosis) • Post seizure drowsiness (post-ictal) • Memory loss • Respiratory failure

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