PRESENTATION BY:CRISHONA BATTLE, SN

ANGELA FUNDERBURK, SNSHANNA HELTON, SNKRYSTLE KELLY, SN

GEORGE NDIRANGU-KAMAU, SNSTEFANIE SMITH, SN

ELIZABETH SNYDER, SN

Seizure

What is a Seizure?

Abnormal, sudden, excessive, uncontrolled electrical discharge of neurons within the brain.

Results in a change in: Level of consciousness Motor or sensory ability And/or behavior

May occur for no reason or may be pathological in nature- resulting from another cause.

Epilepsy: is defined by the National Institute of Neurological disorders and stroke as: Two or more seizures experienced by a person. A chronic disorder in which repeated unprovoked seizure activity

occurs.

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

Types of Seizures

Generalized: involves both hemispheres of the brain. Tonic-clonic: 2-5 minutes, begins with stiffening then

rhythmic jerking of all extremities. Tonic: abrupt increase in muscle tone, loss of consciousness,

& autonomic changes. Lasts 30 seconds- several minutes. Clonic: muscle contraction and relaxation. Lasts several

minutes. Absence: brief loss of consciousness that consists of staring

and automatisms. Mostly in children, may happen 100+/day. Myoclonic: brief jerking or stiffening of extremities, may be

symmetric or asymmetric lasting just a few seconds. Atonic (akinetic): sudden loss of muscle tone causing the

person to fall, lasting for seconds, and most resistant to medications.

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

Types of seizures

Partial: begin in a part of one cerebral hemisphere. Complex-partial: causes syncope for 1-3 minutes- temporal

lobe- psychomotor/ temporal lobe seizures. Impairs consciousness; person may wander and have amnesia.

Simple-partial: consciousness intact. May experience one sided movement of extremities, unusual sensations, & autonomic changes.

Unclassified: occur for no known reason. Primary: not associated with any identifiable brain lesion or

other cause. Idiopathic. Secondary: result from underlying brain lesion

(tumor/trauma). May be caused by: Metabolic disorders, electrolyte imbalance, high fever, stroke,

head injury, substance abuse, & heart disease.

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

•INFORMATION REGARDING A SEIZURE• Pathophysiology and possible causes and risk factors

•WHAT THE LAB VALUES MIGHT LOOK LIKE•WHAT TO LOOK OUT FOR•PATIENT DEMOGRAPHICS•TYPES OF MEDICATIONS

RN giving SN report on the client admitted with

Seizures

Seizure client report

Common Medications for a SeizureMedication Indications Nursing

Interventions

Tegratol Partial, generalized, tonic-clonic seizures.

Monitor for H/A, dizziness, diplopia, N/V, & leukopenia.

Depakote All types of seizures Monitor for hair loss, tremor, increased liver enzymes, bruising, N/V, CBC, PT, PTT, & AST.

Keppra Partial seizures Monitor renal function, gait & coordination problems.

Dilantin All types, except absence, myoclonic, & atonic seizures; for status Epilepticus.

Monitor for GI upset, gengivial hyperplasia, anemia, ataxia, nystagmus, CBC, CA levels, & therapeutic levels.

Klonopin Absence, myoclonic, & akinetic seizures.

Monitor liver function.

Valium/Ativan Status Epilepticus Monitor airway, breathing, & circulation.

Topamax Adjunctive therapy for intractable partial seizures.

Monitor for ataxia, confusion, dizziness, fatigue, & increased renal calculi.

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

•P R O T E C T PAT I E N T F R O M I N J U RY•D O N O T F O R C E A N Y T H I N G I N T O PAT I E N T S M O U T H .

•T U R N PAT I E N T T O S I D E T O P R O T E C T A I RWAY ( P R E V E N T A S P I R AT I O N ) .

•L O O SE N A N Y R E S T R I C T I V E C L O T H I N G.•M A I N TA I N A I RWAY A N D S U C T I O N A S N E E D E D.

•D O N O T R E S T R A I N O R T RY T O S T O P T H E PAT I E N T ’ S M OV E M E N T; G U I D E M OV E M E N T S I S N E C E SS A RY.

•R E C O R D T I M E S E I Z U R E B E G A N & E N D E D.•AT C O M P L E T I O N O F S E I Z U R E :

• Take vital signs• Perform Neuro check• Keep patient on side• Allow patient to rest

• Document the seizure.

Nursing interventions when a client is having a Seizure

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

What to do in the event of a seizure

•I M P O R TA N C E O F TA K I N G A L L M E D S• Prevent reoccurrence. • Maintenance of therapeutic levels- blood draws.

•D O N O T TA K E A N Y M E D S U N L E S S Y O U TA L K T O Y O U R D R . F I R S T.• Prevent drug-drug reactions

•F / U W I T H D R . / N E U R O L O G I S T.•W E A R A M E D I C A L A L E R T B R A C E L E T. •B E S U R E A FA M I LY M E M B E R / F R I E N D I S W I T H Y O U AT A L L T I M E S.•B E S U R E FA M I LY / F R I E N D S K N O W W H AT T O D O I F Y O U H AV E A S E I Z U R E .•D O N O T D R I V E / O P E R AT E H E AV Y M A C H I N E RY.•AV O I D A L C O H O L A N D E X C E S S I V E S T R E S S.•H O M E S A F E T Y E XA M P L E S :

• Cook with non-glass wear• Use pre-cut items- avoid knives• No baths, only showers- use a shower chair• Non-skid bath mats.• Keep home free of clutter.

D/C Teaching for the client with Seizures…

Home safety and health maintenance.

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B Saunders.

Seizure D/C teaching

REFERENCES

Ignatavicius, D., & Workman, L. (2010). Medial-surgical nursing: Patient Centered Collaborative Care (6th ed.). Philadelphia: W.B

Saunders.

We would like to thank 4 Ardmore at Wake Forrest Baptist Medical Center for lending us space to film and being so helpful with our project and clinical rotation. Thank you!!!!