SEIZURE
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in
your behaviour, movements or feelings, and in levels of consciousness.
PATHPOPHYSIOLOGY
Underlying Etiology
(Any process that can disrupt neuronal function and connectivity)
Epileptogenesis
(Mechanism in which brain turn epileptic)
PDSAFTER HYPERPOLARIZATION DISRUPTION
Seizure focus
SEIZURE
Seizure related to neuronal injury
Further seizure
PRIORITIZED NURSING PROBLEM FOR ANEMIA
Nursing Diagnosis Nursing Intervention Rationale
Risk for Trauma or Independent
Suffocation
1. Determine factors related to ● Influences the scope and
the individual situation: intensity of interventions to
Weakness, balancing manage the threat to safety.
difficulties; reduced
muscle, hand or eye
coordination
Poor vision
Reduced sensation
Cognitive limitations or
altered consciousness
Loss of large or small
muscle coordination ● Enables patients to protect
Emotional difficulties self from injury and
recognize changes that
2. Explore and expound require notification of
seizure warning signs (if physician and further
appropriate) and usual intervention. Knowing what
seizure patterns. Teach SO to do when a seizure occurs
to determine and familiarize can prevent injury or
warning signs and how to complications and decreases
care for the patient during SO’s feelings of
and after seizure attacks. helplessness.
● Affects the client’s ability to
protect self and others, and
3. Note client’s age, gender, influences the choice of
developmental age, and interventions and teaching.
decision-making ability,
level of cognition or
competence. ● Prevents or minimizes injury
when seizures (frequent or
4. Use and pad side rails with generalized) occur while the
the bed in lowest position, patient is in bed. Note: Most
or place the bed up against individuals seize in place and
the wall and pad floor if if, in the middle of the bed,
rails are not available or the individual is unlikely to
appropriate. fall out of bed.
5. Ascertain knowledge of ● Alcohol, various drugs, and
various stimuli that may other stimuli (loss of sleep,
precipitate seizure activity. flashing lights, prolonged
television viewing) may
increase brain activity,
thereby increasing the
6. Uphold strict bed rest if potential for seizure activity.
prodromal signs or aura
experienced. Explain the ● Patients may feel restless or
necessity for these actions. need to ambulate or even
defecate during aural phase,
thereby inadvertently
removing themselves from a
safe environment and easy
observation. Understanding
7. Do not leave the patient the importance of providing
during and after a seizure. for your own safety needs
may enhance patient
8. Turn head to side and cooperation.
suction airway as indicated.
Insert plastic bite blocks ● Promotes safety measures.
only if the jaw is relaxed.
● Helps maintain airway
patency and reduces the risk
of oral trauma but should not
be “forced” or inserted when
9. Support the head, place on teeth are clenched because
soft areas or assist the floor dental and soft-tissue
if out of bed. Do not attempt damage may result.
to restrain. Note: Wooden tongue blades
should not be used because
they may splinter and break
in the patient’s mouth.
● Supporting the extremities
10. Provide neurological or vital lessens the risk of physical
sign check after seizure injury when the patient lacks
(level of consciousness, voluntary muscle control.
orientation, ability to Note: If the attempt is made
comply with simple to restrain the patient during
commands, ability to speak; a seizure, erratic movements
memory of incident; may increase, and the patient
weakness or motor deficits; may injure himself or others.
blood pressure (BP), pulse
and respiratory rate).
● Documents postictal state
and time or completeness of
Dependent recovery to a normal state.
May identify additional
1. Review diagnostic studies or safety concerns to be
laboratory tests for addressed.
impairments and
imbalances.
2. Carry out medications as
indicated:
a. Antiepileptic drugs
(AEDs)
● Such may result in or
exacerbate conditions, such
as confusion, tetany,
pathological fractures, etc.
b. Topiramate
(Topamax),
ethosuximide
(Zarontin), ● AEDs raise the seizure
lamotrigine threshold by stabilizing
(Lamictal), nerve cell membranes,
gabapentin reducing the excitability of
(Neurontin) the neurons, or through
direct action on the limbic
c. Phenobarbital system, thalamus, and
(Luminal) hypothalamus.
● Adjunctive therapy for
partial seizures or an
alternative for patients when
d. Lorazepam (Ativan) seizures are not adequately
controlled by other drugs.
e. Diazepam (Valium,
Diastat rectal gel) ● Potentiates and enhances the
effects of AEDs and allows
for lower dosage to reduce
side effects.
● Used to abort status seizure
f. Glucose, thiamine activity because it is shorter
acting than Valium and less
likely to prolong post-seizure
sedation.
Interdependent ● May be used alone (or in
combination with
1. Prepare for surgery or phenobarbital) to suppress
electrode implantation as status seizure activity.
indicated. Diastat, a gel, may be
administered rectally, even in
the home setting, to reduce
the frequency of seizures and
need for additional medical
care.
● May be given to restore
metabolic balance if a
seizure is induced by
hypoglycemia or alcohol.
● Vagal nerve stimulator,
magnetic beam therapy, or
other surgical intervention
(temporal lobectomy) may
be done for intractable
seizures or well-localized
epileptogenic lesions when
the patient is disabled and at
high risk for serious injury.
Reference:
https://nurseslabs.com/4-seizure-
disorder-nursing-care-plans/
