Hello Everyone, here is a Neurological Disorder lecture on Seizures made easy to understand to help aide in your study sessions. I have gathered all of the important information from my Med- Surg Book (Brunners and Suddarth 12th edition) that will prepare you for your nursing test whether it is for school or NCLEX.
Part 2 of this lecture will be located under the Pharmacology section due to the fact that it will cover more about the treatment of various medications.
Here are some Extra information that may help & guide you to all that you want to know about seizures:
Seizure Surgical Management
Surgery is indicated for patients whose epilepsy results from intracranial tumors, abscesses, cysts, or vascular anomalies. Some patients have intractable seizure disorders that do not respond to medication. A focal atrophic process may occur secondary to trauma, inﬂammation, stroke, or anoxia. If the seizures originate in a reasonably well-circumscribed area of the brain that can be excised without producing signiﬁcant neurologic deﬁcits, the removal of the area generating the seizures may produce long-term control and improvement (AANN, 2007).
When seizures are refractory to medication in adolescents and adults with partial seizures, a generator may be implanted under the clavicle. The device is connected to the vagus nerve in the cervical area, where it delivers electrical signals to the brain to control and reduce seizure activity (AANN, 2007). An external programming system is used by the physician to change stimulator settings. Patients can turn the stimulator on and off with a magnet (Krapohl, Deutinger & Komurcu, 2007). More research is needed to determine the effects of the various surgical approaches on complication rates, quality of life, anxiety, and depression, all of which are issues for patients with epilepsy.
Epilepsy is a group of syndromes characterized by unprovoked, recurring seizures (AANN, 2007). Epileptic syndromes are classiﬁed by speciﬁc patterns of clinical features including age at onset, family history, and seizure type. Types of epilepsies are differentiated by how the seizure activity manifests (see Chart 61-3), the most common syndromes being those with generalized seizures and those with partial-onset seizures (Hickey, 2009). Epilepsy can be primary (idiopathic) or secondary (when the cause is known and the epilepsy is a symptom of another underlying condition, such as a brain tumor).
Messages from the body are carried by the neurons (nerve cells) of the brain by means of discharges of electrochemical energy that sweep along them. These impulses occur in bursts whenever a nerve cell has a task to perform. Sometimes, these cells or groups of cells continue ﬁring after a task is ﬁnished. If these uncontrolled, abnormal discharges occur repeatedly, a person is said to have an epileptic syndrome. Epilepsy is not associated with intellectual level. People who have epilepsy without other brain or nervous system disabilities fall within the same intelligence ranges as the overall population. Epilepsy is not synonymous with mental
retardation or illness. However, many people who have developmental disabilities because of serious neurologic damage also have epilepsy.
CORRECTION: Nursing Care During a Seizure
• Provide privacy and protect the patient from curious onlookers. (The patient who has an aura [warning of an impending seizure] may have time to seek a safe, private place.)
• Ease the patient to the ﬂoor, if possible.
• Protect the head with a pad to prevent injury (from striking a hard surface).
• Loosen constrictive clothing.
• Push aside any furniture that may injure the patient during the seizure.
• If the patient is in bed, remove pillows and raise side rails.
• If an aura precedes the seizure, insert an oral airway to reduce the possibility of the patient’s biting the tongue or cheek.
• Do not attempt to pry open jaws that are clenched in a spasm or to insert anything. Broken teeth and injury to the lips and tongue may result from such an action.
• No attempt should be made to restrain the patient during the seizure, because muscular contractions are strong and restraint can produce injury.
If Possible, place the patient on one side with head ﬂexed forward, which allows the tongue to fall forward and facilitates drainage of saliva and mucus. If suction is available, use it if necessary to clear secretions.
Nursing Care After the Seizure
• Keep the patient on one side to prevent aspiration. Make sure the airway is patent.
• There is usually a period of confusion after a grand mal seizure.
• A short apneic period may occur during or immediately after a generalized seizure. • The patient, on awakening, should be reoriented to the environment.
• If the patient becomes agitated after a seizure (postictal), use persuasion and gentle restraint to assist him or her to stay calm.