ASSESSMENT
A patient suddenly becomes unresponsive, with rhythmic jerking of all extremities. What type of seizure is most likely occurring?
Generalized tonic-clonic seizure.
What is the FIRST nursing action when a patient begins seizing?
Protect the airway and prevent injury (turn patient to side, remove hazards).
What is the mechanism of action of Lorazepam in seizure control?
Enhances GABA activity, inhibiting neuronal firing.
What is the greatest immediate risk during a seizure?
Airway obstruction and hypoxia.
Why should oxygen be administered during and after a seizure?
To prevent hypoxia and support brain oxygenation.
A patient reports a strange smell and a feeling of déjà vu prior to a seizure. What is this called?
Aura (focal seizure onset).
Why should nothing be placed in the patient’s mouth during a seizure?
Risk of aspiration and injury; cannot prevent tongue swallowing.
Why is Phenytoin used after benzodiazepines in seizure management?
Provides long-term seizure control by stabilizing neuronal membranes.
Why are patients with seizures at risk for aspiration?
Loss of airway control and gag reflex during seizures.
Why is it important to time the duration of a seizure?
Determines severity and need for emergency intervention (status epilepticus if >5 min).
A patient has lip smacking and repetitive hand movements but remains unaware. What type of seizure is this?
Focal impaired awareness seizure (complex partial seizure).
A patient is actively seizing for over 5 minutes. What is the priority intervention?
Administer a benzodiazepine such as Lorazepam.
A patient receiving Phenytoin develops swollen, bleeding gums. What adverse effect is this?
Gingival hyperplasia.
What is a major complication of prolonged seizures?
Brain damage due to prolonged hypoxia.
A patient refuses anticonvulsant medication. What is the nurse’s best response?
Educate that noncompliance increases risk of recurrent seizures and injury.
A patient remains confused and drowsy after a seizure. What phase is this?
Postictal phase.
After a seizure ends, what is the nurse’s priority assessment?
Airway, breathing, and oxygenation.
Why must cardiac monitoring be used when administering IV Phenytoin?
Risk of arrhythmias and hypotension.
A patient has repeated seizures without recovery. What life-threatening complication can occur?
Status epilepticus leading to respiratory failure.
Why should patients avoid sleep deprivation?
Sleep deprivation can trigger seizures.
A patient experiences continuous seizures without regaining consciousness between them. What condition is this?
Status epilepticus (medical emergency).
A patient in status epilepticus is not responding to initial benzodiazepine therapy. What is the next medication class to administer?
Anticonvulsant such as Phenytoin or Levetiracetam.
What is the advantage of Levetiracetam compared to older anticonvulsants?
Fewer drug interactions and better safety profile.
Why can repeated seizures lead to metabolic acidosis?
Increased muscle activity and hypoxia lead to lactic acid buildup.
A patient asks why alcohol should be avoided. What is the best explanation?
Alcohol lowers seizure threshold and increases risk of seizures.