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NURSING HESI MED SURG STUDY GUIDE LATEST UPDATE [test your skills] 100% A GRADED

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Seizures (6) • Identify different types of Seizures o Partial / Focal Seizures involves one hemisphere of the brain ▪ Complex Partial (Focal Motor Seizure) • Impairment of awareness, associated with automatisms such as o Lip smacking o Chewing at clothes o Fidgeting and other involuntary but coordinated movements • Loss of consciousness or black out for several minutes • Amnesia can occur immediately prior to and after seizures. ▪ Simple Partial Sensory (Focal non-motor seizure) • Unusual sensations affecting o Vision o Smell o Taste o Touch o Hearing • Consciousness maintained ▪ Simple Partial Psychological (Focal non-motor seizure) • Memory or emotional disturbances • Déjà vu • Consciousness maintained ▪ Simple Partial Motor (Focal motor seizure) • Unilateral abnormal extremity movement o Head turning spasms o Generalized Seizures involves two hemispheres of the brain ▪ Grand Mal / Tonic-Clonic / Generalized • Start by having an aura (seeing or hearing something that is not there) o First experience unconsciousness, muscle stiffness followed by 1 -2 minutes of rhythmic jerking of extremities. ▪ Biting of the tongue can occur o Breathing can stop during tonic phase of irregular during colic phase. ▪ Absence • Brief loss of consciousness • Simple staring episode ▪ Myoclonic • Can be symmetrical or asymmetrical • Brief jerking or stiffening of extremities • Last seconds ▪ Clonic • Repetitive jerking movements • Muscle contracts then relaxes • Lasts several minutes ▪ Tonic • Increase in muscle tone o Muscle stiffness and rigidity • Loss of consciousness • Last about 30 seconds to several minutes. • Associated autonomic manifestations o Arrhythmia o Apnea o Vomiting o Incontinence ▪ Atonic /Akinetic • Loss of muscle tone • Frequently results in falling • Postictal Phase o After a seizure o Fatigue and confusion o Maintain side lying to prevent aspiration o Suction as needed o Assess and monitor vital signs o Allow rest o Determine trigger

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Publié le
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Écrit en
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NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE [test your skills] 100% A GRADED
Med-Surg Study Guide
Seizures (6)

• Identify different types of Seizures
o Partial / Focal Seizures involves one hemisphere of the brain

▪ Complex Partial (Focal Motor Seizure)
• Impairment of awareness, associated with automatisms

such as
o Lip smacking

o Chewing at clothes

o Fidgeting and other involuntary but

coordinated movements
• Loss of consciousness or black out for several minutes

• Amnesia can occur immediately prior to and after

seizures.
▪ Simple Partial Sensory (Focal non-motor seizure)
• Unusual sensations affecting

o Vision
o Smell
o Taste
o Touch
o Hearing
• Consciousness maintained

▪ Simple Partial Psychological (Focal non-motor seizure)
• Memory or emotional disturbances


NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE
1|Page
[test your skills] 100% A GRADED

,NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE [test your skills] 100% A GRADED
• Déjà vu

• Consciousness maintained

▪ Simple Partial Motor (Focal motor seizure)
• Unilateral abnormal extremity movement

o Head turning spasms

o Generalized Seizures involves two hemispheres of the brain

▪ Grand Mal / Tonic-Clonic / Generalized
• Start by having an aura (seeing or hearing something

that is not there)
o First experience unconsciousness, muscle

stiffness followed by 1 -2 minutes of
rhythmic jerking of extremities.
▪ Biting of the tongue can occur

o Breathing can stop during tonic phase of irregular

during
colic phase.
▪ Absence
• Brief loss of consciousness

• Simple staring episode




NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE
2|Page
[test your skills] 100% A GRADED

,NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE [test your skills] 100% A GRADED

▪ Myoclonic
• Can be symmetrical or asymmetrical

• Brief jerking or stiffening of extremities
• Last seconds

▪ Clonic
• Repetitive jerking movements
• Muscle contracts then relaxes

• Lasts several minutes

▪ Tonic
• Increase in muscle tone

o Muscle stiffness and rigidity

• Loss of consciousness

• Last about 30 seconds to several minutes.

• Associated autonomic manifestations

o Arrhythmia

o Apnea

o Vomiting

o Incontinence

▪ Atonic /Akinetic
• Loss of muscle tone
• Frequently results in falling

• Postictal Phase
o After a seizure

o Fatigue and confusion

o Maintain side lying to prevent aspiration

NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE
3|Page
[test your skills] 100% A GRADED

, NURSING HESI MED SURG STUDY GUIDE LATEST
UPDATE [test your skills] 100% A GRADED

o Suction as needed

o Assess and monitor vital signs

o Allow rest

o Determine trigger

• Nursing interventions/actions associated with seizure documentation
o Glasgow coma scale is used

o Seizure Precautions

▪ Oxygen and suction apparatus available

▪ Privacy provided as soon as possible

▪ Side rails up and padded (can use blankets, towels, ect)

▪ Bed in lowest position

▪ Pillow under head

▪ Patient in side-lying position (immediately post seizure)

o Document the events leading to and occurring during and after seizure

o Nursing Care during a seizure

▪ Ease patient to the floor

▪ Protect head with a pad to prevent injury




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UPDATE
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[test your skills] 100% A GRADED
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