NUR 148 EXAM 2 GUIDE WITH
COMPLETE SOLUTION
Define epilepsy - ANSWER recurrent, unprovoked seizures
define seizure - ANSWER abnormal, sudden, excessive, uncontrolled electrical
discharge of neurons within the brain that may result in a change in LOC,
motor or sensory ability and behavior
Trigger for seizures - ANSWER - stress
- fatigue
- strobe lights
- stimulants
- low sodium
- low sugar levels
- high fever
What is a tonic-clonic seizure? - ANSWER seizure that lasts longer than 2-5
min begins stiffening or ridigty of muscles (arms & legs) and immediate loss
of consciousness
What is a clonic seizure? - ANSWER rhythmic jerking/relaxing of all
extremities, can last for minutes.
s/s: blank stare, no response, smack their lips or swallow repeatedly, pick at
the air/things, repetition of the same word
,what is a tonic seizure? - ANSWER abrupt increase in muscle tone, loss of
consciousness and automatic changes lasting from 30 seconds to several
minutes
What is a myoclonic seizure? - ANSWER brief jerking or stiffening of the
extremities that may occur singly or in groups, can last for a few seconds, the
contractions may be symmetric (both sides) or asymmetric (one-side)
what is an atonic seizure? - ANSWER sudden loss of muscle tone, followed by
postictal confusion (happens after the seizure)
what is a complex partial seizure? - ANSWER may cause loss of consciousness
(syncope) or black out for 1-3 min. pt may wonder unaware of environment
at the start of the seizure. Involves the temporal lobe can be called
psychomotor/temporal lobe seizures.
what is a simple partial seizure? - ANSWER remains conscious during the
seizure, often reports and aura before that may consist of déjà vu
phenomenon (sudden smell or pain)
what is an unclassified/idiopathic seizure? - ANSWER account for half of all
seizures and occur for no known reason
What is a status epilepticus seizure? - ANSWER prolonged seizure lasting
longer than 5 minutes or repeated seizure lasting over the course of 30 min
- treated with with IV-push lorazepam, diazepam or rectal diazepam
Common causes for a seizure - ANSWER - metabolic disorder, -acute alcohol
withdrawal - electrolyte imbalance
(hyperkalemia, water intoxication, hypoglycemia, low sodium)
,- high fever
- stroke
- head injury
- substance abuse
- heart disease
medications for seizures - ANSWER § Phenytoin: given to prevent additional
tonic-clonic seizure or cardiac arrest a loading dose is given at no more than
50 mg/min or given as a push in a normal saline line make sure to flush
before and after (given 2nd)
· Teaching: drug levels are checked every 6-12hr and 2 weeks after oral
dose
§ Fosphenytoin: water-soluble phenytoin prodrug, compatible with most IV
solutions and also causes fewer cardo complications (given 2nd)
§ Lorazepam (Ativan): 4mg over a 2 min period and can be repeated until
8mg given as an IV push, given first
§ Diazepam: IV push or rectal gel, given first
· Teaching: patient should get blood levels monitored, take same time, do
not eat grapefruit/juice or other citrus fruits (interferes with metabolism and
cause drug toxicity)
seizure precautions - ANSWER - oxygen and suction equipment in the room
- saline lock IV
, - side rails
- padded tongue blade do not belong at bedside and should not be inserted
into the patient's mouth due to high risk of breaking teeth and aspirating
them and improper placement can block airway
What is Parkinson's disease? - ANSWER Also referred to as paralysis agitans,
is a progressive neurodegenerative disease and is one of the most common
neurologic disorder of older people
stages of parkinson disease - ANSWER Stage 1: Initial Stage
-Unilateral limb involvement
- Minimal weakness
- Hand and arm trembling
Stage 2: Mild Stage
- Bilateral limb involvement
- Mask Like face
- Slow, shuffling gait
Stage 3: Moderate Disease
- Postural instability (loss of balance and Bradykinesia)
COMPLETE SOLUTION
Define epilepsy - ANSWER recurrent, unprovoked seizures
define seizure - ANSWER abnormal, sudden, excessive, uncontrolled electrical
discharge of neurons within the brain that may result in a change in LOC,
motor or sensory ability and behavior
Trigger for seizures - ANSWER - stress
- fatigue
- strobe lights
- stimulants
- low sodium
- low sugar levels
- high fever
What is a tonic-clonic seizure? - ANSWER seizure that lasts longer than 2-5
min begins stiffening or ridigty of muscles (arms & legs) and immediate loss
of consciousness
What is a clonic seizure? - ANSWER rhythmic jerking/relaxing of all
extremities, can last for minutes.
s/s: blank stare, no response, smack their lips or swallow repeatedly, pick at
the air/things, repetition of the same word
,what is a tonic seizure? - ANSWER abrupt increase in muscle tone, loss of
consciousness and automatic changes lasting from 30 seconds to several
minutes
What is a myoclonic seizure? - ANSWER brief jerking or stiffening of the
extremities that may occur singly or in groups, can last for a few seconds, the
contractions may be symmetric (both sides) or asymmetric (one-side)
what is an atonic seizure? - ANSWER sudden loss of muscle tone, followed by
postictal confusion (happens after the seizure)
what is a complex partial seizure? - ANSWER may cause loss of consciousness
(syncope) or black out for 1-3 min. pt may wonder unaware of environment
at the start of the seizure. Involves the temporal lobe can be called
psychomotor/temporal lobe seizures.
what is a simple partial seizure? - ANSWER remains conscious during the
seizure, often reports and aura before that may consist of déjà vu
phenomenon (sudden smell or pain)
what is an unclassified/idiopathic seizure? - ANSWER account for half of all
seizures and occur for no known reason
What is a status epilepticus seizure? - ANSWER prolonged seizure lasting
longer than 5 minutes or repeated seizure lasting over the course of 30 min
- treated with with IV-push lorazepam, diazepam or rectal diazepam
Common causes for a seizure - ANSWER - metabolic disorder, -acute alcohol
withdrawal - electrolyte imbalance
(hyperkalemia, water intoxication, hypoglycemia, low sodium)
,- high fever
- stroke
- head injury
- substance abuse
- heart disease
medications for seizures - ANSWER § Phenytoin: given to prevent additional
tonic-clonic seizure or cardiac arrest a loading dose is given at no more than
50 mg/min or given as a push in a normal saline line make sure to flush
before and after (given 2nd)
· Teaching: drug levels are checked every 6-12hr and 2 weeks after oral
dose
§ Fosphenytoin: water-soluble phenytoin prodrug, compatible with most IV
solutions and also causes fewer cardo complications (given 2nd)
§ Lorazepam (Ativan): 4mg over a 2 min period and can be repeated until
8mg given as an IV push, given first
§ Diazepam: IV push or rectal gel, given first
· Teaching: patient should get blood levels monitored, take same time, do
not eat grapefruit/juice or other citrus fruits (interferes with metabolism and
cause drug toxicity)
seizure precautions - ANSWER - oxygen and suction equipment in the room
- saline lock IV
, - side rails
- padded tongue blade do not belong at bedside and should not be inserted
into the patient's mouth due to high risk of breaking teeth and aspirating
them and improper placement can block airway
What is Parkinson's disease? - ANSWER Also referred to as paralysis agitans,
is a progressive neurodegenerative disease and is one of the most common
neurologic disorder of older people
stages of parkinson disease - ANSWER Stage 1: Initial Stage
-Unilateral limb involvement
- Minimal weakness
- Hand and arm trembling
Stage 2: Mild Stage
- Bilateral limb involvement
- Mask Like face
- Slow, shuffling gait
Stage 3: Moderate Disease
- Postural instability (loss of balance and Bradykinesia)
