Seizure Disorder for Progressive Care Certified Nurse (PCCN)

Seizure Disorder

Definition/Etiology:

• Increased electrical energy that occurs uncontrollably
• Causes:
  • Changes in intracranial pressure
  • Lack of oxygen
  • Electrolyte imbalances
  • Eclampsia
  • High fever
  • Alcohol/drug withdrawal
  • Low blood sugar
  • Head injury 
  • Stroke

Pathophysiology:

• Neuron (brain cell) excessive electrical impulse.
  • 1 short seizure = usually minimal damage
  • If more frequent or longer= more damage

Noticing: Assessment & Recognizing Cues:

• Types of Seizures
• Generalized Seizures (Tonic-Clonic; Absence)
  • Both hemispheres
  • More severe symptoms
• Focal/partial Seizures (simple; complex)
  • One hemisphere
  • Less severe symptoms
  • Can spread to general
• Status epilepticus (≥5 minutes)
  • Can result in brain death

Warning Signs for seizures

• *Auras* (these vary widely so paying attention to patient is vital)
  • Sensory symptoms
  • Emotional changes
  • Autonomic symptoms

Interpreting: Analyzing & Planning:

• Diagnostics
  • *EEG*
  • CT scan
  • MRI
  • Lumbar puncture

Responding: Patient Interventions & Taking Action:

• Treatment
• Medications
  • Anticonvulsant
  • Benzos
• Surgery
  • Brain tumor
  • Arteriovenous malformation
• Dietary changes
  • Ketogenic diet
• Brain stimulation
• Vagal nerve stimulation

Reflecting: Evaluating Patient Outcomes:

• Safety during the seizure
• Seizure precautions
  • ABCs 1st
  • Turn on side
  • Prevent injury
  • NOTHING in mouth
  • Pad side rails
  • Note time seizure starts/stops

Linchpins (Key Points):

• Brain’s electricity in overdrive.
• Notice= generalized, focal, status epilepticus
• Interpret= EEG
• Respond= Anticonvulsants
• Safety= Seizure precautions