Assessment
What environmental safety measures are required?
Side rails up, controlled noise level, access to oxygen/suction equipment, airway devices, padded rails, IV access.
What lifestyle modifications are recommended?
Regular sleep schedule, medication compliance, avoiding triggers, maintaining seizure diary, and having a safety plan for seizure occurrence.
Why do motor vs non-motor symptoms vary?
Symptoms depend on the seizure’s location in the brain.
What safety precautions would you implement?
Remove hazards, prevent falls, maintain airway, and provide constant supervision as patients may perform dangerous actions like walking into traffic.
Which environmental factors can lower seizure threshold?
Blinking lights, poorly adjusted television screens, loud noises, certain music, certain odours, being startled
What autonomic nervous system responses indicate anxiety/stress?
Cold/clammy hands, diaphoresis, agitation, trembling extremities.
What should patients know regarding grapefruit consumption?
What is the fundamental problem occuring in seizure disorders?
A group of abnormal neurons fire without a clear cause.
What vital signs require immediate attention/monitoring post-seizure?
Airway, breathing, circulation (ABCs); asses for hypoxemia, cardiac dysrhythmias, hyperthermia
What sleep-related factors can trigger seizures?
Sleep deprivation, irregular sleep patterns, and sudden awakening.
Why can’t patients remember events during their seizures?
The impaired consciousness during the seizure prevents for formation of memories, resulting in complete amnesia of the event.
Why must antiepileptic medications be taken at the same time each day?
To maintain consistent therapeutic blood levels and prevent breakthrough seizures.
What occurs in the brain during these seizures?
Seizure activity begins in a specific region of the cortex, affecting the area’s function, and may remain focal or spread.
Your patient reports having an “odd feeling“ before seizures. What assessment would you perform?
Assess for aura characteristics, timing before seizures, associated symptoms like depression, irritability, sleep disruption, nausea, headache
How does dehydration contribute to seizure activity?
It causes electrolyte imbalances and increased neuronal excitability.
What key components should be included in the neurological assessment?
Deep tendon reflexes, bilateral upper/lower extremity sensory/motor testing, headaches, auras, visual changes.
What information should patients receive about missed doses?
Contact healthcare provider immediately if doses are missed, as this increases seizure risk.
What role does GABA (neurotransmitter) play in seizure disorders?
They alter the movement of sodium, potassium, calcium, and magnesium ions to stabilize cell membranes and make neurons less excitable.
What are priority nursing interventions post-ictally?
Monitor consciousness, provide a rest period, assess for injuries, reorient patient, and document duration & characteristics of seizure.
What electrolyte imbalances commonly trigger seizures?
What distinguishes focal impaired awareness seizures from other seizures?
Patients have a loss of consciousness/altered awareness and have no memory of the event.
What warning signs should families watch for?
Unusual behaviours, automatisms (repetitive, purposeless actions like lip smacking) , unresponsiveness to interaction, dreamlike state, and post-seizure confusion or fatigue.
What role do astrocytes play in seizures?
Activation of astrocytes by hyperactive neurons is crucial in causing nearby neurons to generate epileptic discharge.
What specific seizure characteristics should you document?
Duration, type of movements, loss of consciousness, incontinence, post-ictal state, vital signs
What metabolic disturbances can provoke seizures in adults?
Acidosis, electrolytes imbalances, hypoglycemia, hypoxia, alcohol withdrawal, dehydration, and water intoxication.