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Exemplar 11.2: Seizure Disorders

Olivia McRitchie 9 questions

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  1. 1Drag and drop the seizure type with the description.

    [blank_start]Simple partial[blank_end]:
    -Typically only involves motor portion of brain.
    -Manifests as recurrent muscle contractions of face or contralateral part of body.
    -If ANS is disrupted, it may also cause tachycardia, flushing, hypotension, or hypertension.
    -May have psychological manifestations, such as deja vu, inappropriate fear or anger, abnormal sensations, or hallucinations.
    -No alteration in consciousness
    -Involves a restricted part of one cerebral hemisphere.

    [blank_start]Tonic clonic[blank_end]:
    -Sudden loss of consciousness preceded by a warning aura.
    -[blank_start]Clonic phase:[blank_end] Alternating contraction & relaxation of muscles, hyperventilation, eyes rolled back, frothing at the mouth, subsides after 60-90 seconds.
    -[blank_start]Tonic phase[blank_end]: Sharp muscle contraction that forces air out of lungs, loss of postural control, rigid muscles, extended arms and legs, jaw clenched, urinary & bowel incontinence, cessation of breathing & cyanosis, fixed & dilated pupils, lasting 15-60 seconds.
    -[blank_start]Postictal phase[blank_end]: Unconscious & unresponsive, but regaining conscious gradually; relaxed & breathing quietly; may be confused & disoriented when walking; headache, muscle ache, fatigue; may sleep for several hours; amnesia for duration of & after seizure.

    [blank_start]Absence[blank_end]:
    -Impaired level of consciousness
    -Brief cessation of motor activity
    -Blank stare, unresponsiveness,
    -Usually 5-10 seconds.
    -Can be up to several hundred per day.
    -Both hemispheres of brain, as well as deeper structures,

    [blank_start]Status epilepticus[blank_end]:
    -Continual seizure activity w/short periods of calm
    -Any type, but usually generalized tonic-clonic
    -Danger of hypoxia, acidosis, hypoglycemia, hyperthermia, and exhaustion.

    [blank_start]Complex partial[blank_end]:
    -Often proceeded by an aura
    -Impaired consciousness lasting for several hours
    -Repetitive non purposeful activity, called automatisms
    -Amnesia is common after.
    -Activation of only a restricted part of one cerebral hemisphere, usually originating in temporal lobe.
    1. ASimple partial
    2. BTonic clonic
    3. CClonic tonic
    4. DClonic phase:
    5. ETonic phase
    6. FPostictal phase
    7. GAbsence
    8. HStatus epilepticus
    9. IComplex partial
  2. 2Which of the following is NOT a reason that a person may have a seizure?
    1. AGenetic factors
    2. BTrauma
    3. CInfection
    4. DHypoglycemia
    5. EHypotonic dehydration
    6. FElectrolyte imbalances
    7. GEndocrine dysfunction
    8. HToxins
    9. ITumors & lesions
    10. JHypertonic dehydration
  3. 3Anticonvulsant drugs only work by raising the seizure threshold.
    1. ATrue
    2. BFalse
  4. 4Which of the following is NOT an appropriate intervention for status epilepticus?
    1. AMaintaining a patent airway w/jaw thrust maneuver & oxygen
    2. BEstablishing an IV line
    3. CAdministering 50% dextrose
    4. DAdminister diazepam, lorazepam, for midazolam IV every 10 minutes until seizure activity stops.
    5. EMonitor vital signs and circulation
    6. FKeep suction equipment at bedside
    7. GManage thermoregulation
    8. HPerform neurological assessment
    9. IAdminister carbamazepine and diazepam IV every 15 minutes until seizure activity stops.
  5. 5Select the nursing considerations unique to phenytoin.
    1. AGingival hyperplasia
    2. BMonitor serum calcium level
    3. CAdminister 2 hours after antacids.
    4. DAdminister with food.
  6. 6You have a 23-year-old patient with epilepsy. She is being given primidone to control her seizures. What would you be looking for in this patient?
    1. ADrops in blood pressure, heart rate, and respirations.
    2. BBlurred or dimmed vision
    3. CSlurred speech
    4. DNystagmus
    5. EConfusion
    6. FIncreases in blood pressure, heart rate, and respirations
    7. GNervousness
    8. HDry mouth
  7. 7You have a patient brought into the E.D. following a seizure in the department store. She is conscious, but disoriented and sleepy. She reports that one second she had a ringing in her ears and felt "out-of-body" and the next she's on the floor with a 7/10 headache and people around her "freaking out". She reports that this has never happened before.

    You believe that she had a tonic-clonic seizure, but you need to get a clearer image. The patient's husband watched the whole episode. Which of the following questions is inappropriate for the information you currently have?
    1. A"What was your wife doing just before the seizure?"
    2. B"Were you able to see what part of the body the seizure started in?"
    3. C"Did she make a loud noise before she fell?"
    4. D"Can you describe the movements she was making after she fell? Did the location and character change at some point in time?"
    5. E"Did you notice her head or eyes turn to one side before the seizure started?"
    6. F"Did she hit her head when she fell?"
    7. G"Was she foaming or frothing at the mouth?"
    8. H"Did you notice eyelid fluttering, chewing, lip smacking, or swallowing?"
  8. 8You are teaching a group of employees at a department store about what to do if a customer has a seizure. Which of the following statements made by an employee shows that more teaching is needed?
    1. A"I need to put something in the customer's mouth to prevent tongue biting,"
    2. B"I will position the customer on his/her side."
    3. C"I will move any objects that may be around the customer."
  9. 9Oxygen should be administered to the seizing patient immediately.
    1. ATrue
    2. BFalse

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Description
NCLEX Nursing (Medical-Surgical) Quiz on Exemplar 11.2: Seizure Disorders, created by Olivia McRitchie on 02/10/2018.
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