Seizures - Pathophysiology PDF

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Pathophysiology
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Rebekah Taylor October 5, 2020 NSG 210 Ms. Thornton 2A Clinical Rotation Seizures

Etiology: Seizures are disturbances within the brain that are sudden as well as uncontrolled. These disturbances can cause alterations of mood, behaviors, as well as consciousness. There are many different types of seizures that are graded based on severity and where they take place in the brain. If a seizure lasts more than 5 minutes, it is considered a medical emergency. Many seizures have unknown causes however, some have underlying causes of illnesses. Most common of seizures is epilepsy. Some seizures can happen due to fever, decreased sleep, hyponatremia, medications, head trauma, stroke, brain tumor, drugs, alcohol abuse. Risk Factors: Even though epilepsy has no cause that is identifiable there are still some factors that can be traced. Seizures can mostly be linked to: o o o o o o

Genetics Head trauma Brain conditions Infectious disease Prenatal injury Developmental disorders

Signs and Symptoms: These can range from mild to severe as well as vary. They may include: o o o o o

Confusion that is temporary Staring blankly Jerking movements that are uncontrollable mainly of the arms and legs Loss of consciousness and/or awareness Can be focal or generalized  Focal  Mainly one portion of the brain  Generalized  Involve all areas of the brain o Absence—staring into space o Tonic—stiffening of muscles o Atonic—loss of muscle control o Clonic—repeated muscle movement o Myoclonic—brief jerks o Tonic-Clonic—stiffening and shaking

Nursing Interventions: The main intervention is to promote safety for the patient. However, there are some other, they consist of:

Rebekah Taylor October 5, 2020 NSG 210 Ms. Thornton 2A Clinical Rotation o Prevent trauma/injury  Use tympanic thermometer  Support head on soft area  Turn patient to left side  Assist to floor  Do not restrain  Document seizure activity o Airway clearance—  Loosen clothing from neck and abdominal areas  Suction as needed  Turn head during seizure  Provide supplemental oxygen or bag valve mask o Improve self-esteem  Encourage activities  Provide supervision and monitoring as needed  Avoid judgmental conversations o Teach patient about condition  Discuss triggers  Encourage good hygiene and dental care  Review medications  Physician care and not stopping medication or regimen unless discussed with physician o Post-seizure treatment  Assess vitals; respirations and pulse  Cover patient with blanket  Reassure patient  Reorient patient  Perform a neurological assessment Diagnosis: Once you have had a seizure a physician will do an extensive exam that goes through the symptoms as well as medical history. There are several tests that may be ordered: o o o o o o o

Neurological exam—behavior, motor function, mental function Blood tests—infections, genetic conditions, glucose, electrolyte imbalances Lumbar puncture EEG (electroencephalogram) Computerized tomography (CT) Positron emission tomography (PET) Single-photon emission computerized tomography (SPECT)

Rebekah Taylor October 5, 2020 NSG 210 Ms. Thornton 2A Clinical Rotation Treatment: Seizures can be an isolated event and if it is the first seizure a physician may decided not to start treatment until the patient has another one. Anti-seizure medications can be given. However, finding the right medication as well as the right dose can sometimes be a challenge. If medications are not effective there are some other treatments that may be looked at. These may be: o Surgery—locate and remove area where seizures begin o Vagus nerve stimulation—under the skin and sends signals to inhibit seizures o Responsive neurostimulation—implanted on brain or brain tissue detects seizures and delivers electric stimulation o Deep brain stimulation—implants in certain areas and the impulses regulate brain activity. o Dietary therapy—keto diet (high fat, low carb), Atkins diet (are not as restrictive) Complications: During seizure activity there are some complications that can arise. These are: Falling Drowning Car accidents Pregnancy complications Emotional health concerns—depression and anxiety Status epilepticus—continuous seizure for more than 5 minutes or recurrent without regaining consciousness o Sudden unexpected death in epilepsy (SUDEP)—may occur due to respiratory or heart conditions o o o o o o...