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An electrical storm in the brain

Nursing made Incredibly Easy: July/August 2019 - Volume 17 - Issue 4 - p 1
doi: 10.1097/01.NME.0000568820.12663.db
CE Connection

GENERAL PURPOSE: To provide updated information on epilepsy classification, symptoms, diagnostic tools, and management strategies. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Identify categories, classification, signs and symptoms, and diagnostic tests for epilepsy. 2. Describe complications and management strategies for patients diagnosed with epilepsy.

  1. The three categories currently used to identify epilepsy are
    1. grand mal, petit mal, and complex partial.
    2. generalized, focal, and unknown onset.
    3. tonic-clonic, atonic, and impaired awareness.
  2. Generalized seizures affect which side(s) of the brain?
    1. only the left side
    2. only the right side
    3. both the right and left sides
  3. A focal unaware seizure includes
    1. simple partial seizure activity.
    2. being awake during a seizure.
    3. an altered level of consciousness during a seizure.
  4. Muscle twitching occurring during a seizure is referred to as
    1. myoclonus.
    2. tonic movements.
    3. clonic movements.
  5. Unknown onset seizures are characterized by
    1. motor (tonic-clonic) symptoms.
    2. nonmotor (behavior arrest) symptoms.
    3. both motor and nonmotor symptoms.
  6. Which diagnostic tool can show where a seizure starts and how it spreads?
    1. MRI
    2. EEG
    3. PET
  7. SPECT is a diagnostic tool for epilepsy that
    1. detects changes in cell metabolism during a seizure.
    2. identifies areas with structural changes during seizure activity.
    3. pinpoints areas of the brain used for movement associated with seizure activity.
  8. Which statement about status epilepticus is accurate?
    1. Repetitive seizure activity lasts for at least 45 minutes.
    2. There's a periodic return of consciousness throughout the seizure activity.
    3. Cerebral metabolic needs for glucose and oxygen aren't being met during the seizure.
  9. An initial treatment for status epilepticus includes
    1. rectal sodium valproate.
    2. I.V. lorazepam.
    3. I.V. phenobarbital.
  10. Risk factors for SUDEP include
    1. infrequent seizure activity.
    2. generalized convulsive seizures.
    3. onset of seizures at an older age.
  11. AEDs provide
    1. a cure for epilepsy.
    2. effective seizure control for over 85% of patients.
    3. inhibition of neuronal excitation or increase in neuronal inhibition.
  12. Common adverse reactions associated with AEDs include all of the following except
    1. tremors.
    2. swollen gums.
    3. insomnia.
  13. Surgical intervention may be necessary for patients with epilepsy due to ineffective standard medical treatment for up to
    1. 30% of patients.
    2. 50% of patients.
    3. 70% of patients.
  14. For patients with epilepsy, which surgical procedure is most common?
    1. corpus callosotomy
    2. focal resection
    3. MST
  15. Due to standard treatment resistance, the most common type of epilepsy more likely to need surgical intervention is
    1. parietal lobe epilepsy.
    2. occipital lobe epilepsy.
    3. temporal lobe epilepsy.
  16. Taken during pregnancy, which AED has the highest risk of lower IQ and autism in the child?
    1. lamotrigine
    2. levetiracetam
    3. sodium valproate
  17. Seizure precaution interventions include
    1. obtaining daily oral temperatures.
    2. placing seizure pads on bedrails.
    3. implementing close supervision but with independent bathroom privileges.
  18. For patients with a history of seizures, safety precautions include
    1. taking a bath instead of a shower.
    2. using safety measures when cooking.
    3. avoiding driving until starting an AED.
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