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Diseases » Petit mal seizures » Treatments
 

Treatments for Petit mal seizures

Contents
  1. Petit mal seizures: Introduction
  2. Buy Products Related to Treatments for Petit mal seizures
  3. Petit mal seizures: Introduction

Petit mal seizures: Research Doctors & Specialists

Research all specialists including ratings, affiliations, and sanctions.

Drugs and Medications used to treat Petit mal seizures:

Note:You must always seek professional medical advice about any prescription drug, OTC drug, medication, treatment or change in treatment plans.

Some of the different medications used in the treatment of Petit mal seizures include:

  • Clonazepam
  • Apo-Clonazepam
  • Klonopin
  • Med-Klonazepam
  • Novo-Clonazepam
  • Rhoxal-Clonazepam
  • Rivotril
  • Valproic Acid
  • Alti-Valproic
  • Apo-Divalproic
  • Apo-Valproic
  • Atemperator
  • Depa
  • Depakene
  • Depakote
  • Depakote ER
  • Deproic
  • Epival
  • Myproic
  • Novo-Divalproex
  • Novo-Valproic
  • Nu-Valproic
  • Rhoproic
  • Valproic
  • Alti-Clonazepam
  • Clonapam
  • Gen-Clonazepam
  • Nu-Clonazepam
  • PMS-Clonazepam
  • Rho-Clonazepam
  • Kenoket
  • Medium Chain Triglycerides
  • MCT Oil
  • Methsuximide
  • Celontin

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Book Excerpts: Treatment of Petit mal seizures

Treatments of Petit mal seizures: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Petit mal seizures.

Chorea: Treatment
(In a Page: Signs and Symptoms)

  • Huntington's disease: Antidepressants may reduce depressive symptoms; neuroleptics (e.g., haloperidol, clozapine) may suppress choreic movements; disease is progressive and fatal; genetic counseling is suggested
  • Sydenham's chorea is usually self-limited with symptom resolution within 15 weeks
  • Acute rheumatic fever: Corticosteroids may shorten course of chorea; antibiotic therapy with penicillin for at least 10 days
  • Drug-induced chorea: Discontinue or reduce dosage of implicated medications; atypical neuroleptics are associated with decreased risk of involuntary movements
  • Chorea gravidarum may require delivery
  • Wilson's disease: Copper-chelating agents
  • Neuroacanthocytosis: Usually fatal within 9 years of symptom onset
  • Specific therapy for lupus, hyperthyroidism, AIDS

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Seizures/Convulsions: Treatment
(In a Page: Signs and Symptoms)

  • Generalized status epilepticus (continuous or recurrent seizure activity without a return to baseline for >30 minutes) is a medical emergency and should be treated aggressively with IV antiepileptic medications
  • Remove offending intoxicants or medications
  • Correct metabolic abnormalities as necessary
  • Numerous anticonvulsant medications are available for acute and chronic use
    –Select the most appropriate agent on the basis of the clinical situation, seizure type, and side effect profile
    –Combination anticonvulsant therapy may be effective for patients refractory to a single agent
  • Vagus nerve stimulators are effective in patients refractory to anticonvulsant therapy
  • Epilepsy surgery also may be effective in controlling seizures in carefully selected surgical candidates who are refractory to chronic anticonvulsant medication
  • Lifestyle modification and avoidance of triggers (e.g., sleep deprivation, alcohol)

    • » READ BOOK EXCERPT ONLINE »

    Source: In a Page: Signs and Symptoms, 2004

    Chorea: Treatment
    (In A Page: Pediatric Signs and Symptoms)

      • Treatment should be reserved for patients in whom chorea severity interferes with function
        –Simple measures such as rest and avoidance of stress often alleviate symptoms
        –Anti-epilepsy medications are used for paroxysmal choreas
        –Dopamine blockers such as haloperidol and pimozide are used to decrease the movement disorder
      • Sydenham chorea
        –May be treated with valproate or pimozide
        –Immunosuppression with steroids, intravenous immunoglobulin or plasmapheresis have been used
        –Secondary prophylaxis with penicillin is required
    • Wilson disease: Treat with penicillamine, trientene chelation, or zinc
    • In cases of toxin-induced chorea, removal of the offending agent is usually sufficient

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Seizures – Childhood: Treatment
    (In A Page: Pediatric Signs and Symptoms)

    • In the acute setting: First evaluate and secure airway, breathing, and circulation
      –IV benzodiazepines (lorazepam) is first line of treatment; in the absence of IV access, rectal diazepam may be used
      –IV fosphenytoin is the second line of treatment and provides longer seizure suppression
      –If not sufficient, phenobarbital can be added
      –Constant evaluation of the airway during treatment, and, if necessary, intubation is critically important
    • If the seizure continues despite these medications, anesthesia with pentobarbital, midazolam, or propofol may be used to suppress the refractory seizures
    • Long-term prophylaxis can be obtained by one or a combination of anti-epileptic medications
      –Focal seizures: Carbamazepine, oxcarbazepine, gabapentin, levetiracetam, or valproate
      –Absence seizures: Ethosuximide or valproate

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Seizures – Neonatal: Treatment
    (In A Page: Pediatric Signs and Symptoms)

      • Evaluate and secure airway, breathing, and circulation
        –Benzodiazepines or phenobarbital infused intravenously can stop the seizures
    • If there is reason to suspect hypoglycemia, even if blood glucose level cannot be quickly established, treat with glucose intravenously
    • Treat hypocalcemia with calcium gluconate
    • Treat hypomagnesemia with magnesium sulfate
    • Meningitis and HSV encephalitis require intravenous antibiotics and acyclovir, respectively
    • Depending on the etiology, the infant may stay on phenobarbital for varying duration of time
    • Glucose transporter deficiency can be treated with ketogenic diet
    • For pyridoxine deficiency, pyridoxine 50–100 mg injected intravenously during an EEG recording can be both diagnostic and therapeutic

    » READ BOOK EXCERPT ONLINE »

    Source: In A Page: Pediatric Signs and Symptoms, 2007

    Carpopedal spasm: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    If you detect carpopedal spasm, quickly examine the patient for signs of respiratory distress (laryngospasm, stridor, loud crowing noises, cyanosis) or cardiac arrhythmias, which indicate hypocalcemia. Obtain blood specimens for electrolyte analysis (especially calcium), and perform an electrocardiogram. Connect the patient to a cardiac monitor to watch for the appearance of arrhythmias. Administer an I.V. calcium preparation, and provide emergency respiratory and cardiac support. If calcium infusion doesn't control seizures, administer a sedative, such as chloral hydrate or phenobarbital.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Fasciculations: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    Begin by asking the patient about the nature, onset, and duration of the fasciculations. If the onset was sudden, ask about precipitating events such as exposure to pesticides. Pesticide poisoning, although uncommon, is a medical emergency requiring prompt and vigorous intervention. You may need to maintain airway patency, monitor the patient’s vital signs, give oxygen, and perform gastric lavage or induce vomiting.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Level of consciousness, decreased: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    After evaluating the patient’s airway, breathing, and circulation, use the Glasgow Coma Scale to quickly determine his LOC and to obtain baseline data. (See Glasgow Coma Scale.) If the patient’s score is 13 or less, emergency surgery may be necessary. Insert an artificial airway, elevate the head of the bed 30 degrees and, if spinal cord injury has been ruled out, turn the patient’s head to the side. Prepare to suction the patient if necessary. You may need to hyperventilate him to reduce carbon dioxide levels and decrease intracranial pressure (ICP). Then determine the rate, rhythm, and depth of spontaneous respirations. Support his breathing with a handheld resuscitation bag, if necessary. If the patient’s Glasgow Coma Scale score is 7 or less, intubation and resuscitation may be necessary.

    Continue to monitor the patient’s vital signs, being alert for signs of increasing ICP, such as bradycardia and a widening pulse pressure. When his airway, breathing, and circulation are stabilized, perform a neurologic examination.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Myoclonus: Emergency Interventions
    (Handbook of Signs & Symptoms (Third Edition))

    If you observe myoclonus, check for seizure activity. Take the patient’s vital signs to rule out arrhythmias or a blocked airway. Have resuscitation equipment on hand.

    If the patient has a seizure, gently help him lie down. Place a pillow or a rolled-up towel under his head to prevent concussion. Loosen constrictive clothing, especially around the neck, and turn his head (gently, if possible) to one side to prevent airway occlusion or aspiration of secretions.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Seizures, generalized tonic-clonic: Emergency interventions
    (Handbook of Signs & Symptoms (Third Edition))

    If you witness the beginning of the seizure, first check the patient’s airway, breathing, and circulation, and ensure that the cause isn’t asystole or a blocked airway. Stay with the patient and ensure a patent airway. Focus your care on observing the seizure and protecting the patient. Place a towel under his head to prevent injury, loosen his clothing, and move any sharp or hard objects out of his way. Never try to restrain the patient or force a hard object into his mouth; you might chip his teeth or fracture his jaw. Only at the start of the ictal phase can you safely insert a soft object into his mouth.

    If possible, turn the patient to one side during the seizure to allow secretions to drain and to prevent aspiration. Otherwise, do this at the end of the clonic phase when respirations return. (If they fail to return, check for airway obstruction and suction the patient if necessary. Cardiopulmonary resuscitation, intubation, and mechanical ventilation may be needed.)

    Protect the patient after the seizure by providing a safe area in which he can rest. As he awakens, reassure and reorient him. Check his vital signs and neurologic status. Make sure to carefully record these data and your observations during the seizure.

    If the seizure lasts longer than 4 minutes or if a second seizure occurs before full recovery from the first, suspect status epilepticus. Establish an airway, start an I.V. line, give supplemental oxygen, and begin cardiac monitoring. Draw blood for appropriate studies. Turn the patient on his side, with his head in a semi-dependent position, to drain secretions and prevent aspiration. Periodically turn him to the opposite side, check his arterial blood gas levels for hypoxemia, and administer oxygen by mask, increasing the flow rate if necessary. Administer diazepam or lorazepam by slow I.V. push, repeated two or three times at 10- to 20-minute intervals, to stop the seizures. If the patient isn’t known to have epilepsy, an I.V. bolus of dextrose 50% (50 ml) with thiamine (100 mg) may be ordered. Dextrose may stop the seizures if the patient has hypoglycemia. If his thiamine level is low, also give thiamine to guard against further damage.

    If the patient is intubated, expect to insert a nasogastric (NG) tube to prevent vomiting and aspiration. Be aware that if the patient hasn’t been intubated, the NG tube itself can trigger the gag reflex and cause vomiting. Make sure to record your observations and the intervals between seizures.

    » READ BOOK EXCERPT ONLINE »

    Source: Handbook of Signs & Symptoms (Third Edition), 2006

    Carpopedal spasm: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    If you detect carpopedal spasm, quickly examine the patient for signs of respiratory distress (laryngospasm, stridor, loud crowing noises, cyanosis) or cardiac arrhythmias, which indicate hypocalcemia. Obtain blood samples for electrolyte analysis (especially calcium), and perform an electrocardiogram. Connect the patient to a monitor to watch for the appearance of arrhythmias. Administer an I.V. calcium preparation, and provide emergency respiratory and cardiac support. If a calcium infusion doesn’t control seizures, administer a sedative, such as chloral hydrate or phenobarbital.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Fasciculations: Emergency Interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Begin by asking the patient about the nature, onset, and duration of the fasciculations. If the onset was sudden, ask about any precipitating events, such as exposure to pesticides. Pesticide poisoning, although uncommon, is a medical emergency requiring prompt and vigorous intervention. You may need to maintain airway patency, monitor vital signs, give oxygen, and perform gastric lavage or induce vomiting.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Level of consciousness, decreased: Emergency Interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    After evaluating the patient’s airway, breathing, and circulation, use the Glasgow Coma Scale to quickly determine his LOC and to obtain baseline data. (See Using the Glasgow Coma Scale, page 480.) If the patient’s score is 13 or less, emergency surgery may be necessary. Insert an artificial airway, elevate the head of the bed 30 degrees and, if spinal cord injury has been ruled out, turn the patient’s head to the side. Prepare to suction the patient if necessary. You may need to hyperventilate him to reduce carbon dioxide levels and decrease intracranial pressure (ICP). Then determine the rate, rhythm, and depth of spontaneous respirations. Support his breathing with a handheld resuscitation bag, if necessary. If the patient’s Glasgow Coma Scale score is 7 or less, intubation and resuscitation may be necessary.

    Continue to monitor the patient’s vital signs, being alert for signs of increasing ICP, such as bradycardia and widening pulse pressure. When his airway, breathing, and circulation are stabilized, perform a neurologic examination.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Myoclonus: Emergency Interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    If you observe myoclonus, check for seizure activity. Take vital signs to rule out arrhythmias or a blocked airway. Have resuscitation equipment on hand.

    If the patient has a seizure, gently help him lie down. Place a pillow or a rolled-up towel under his head to prevent concussion. Loosen any constrictive clothing, especially around the neck, and turn his head (gently, if possible) to one side to prevent airway occlusion or aspiration of secretions.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Seizures, generalized tonic-clonic: Emergency interventions
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    If you witness the beginning of the seizure, first check the patient’s airway, breathing, and circulation, and ensure that the cause isn’t asystole or a blocked airway. Stay with the patient and ensure a patent airway. Focus your care on observing the seizure and protecting the patient. Place a towel under his head to prevent injury, loosen his clothing, and move any sharp or hard objects out of his way. Never try to restrain the patient or force a hard object into his mouth; you might chip his teeth or fracture his jaw. Only at the start of the ictal phase can you safely insert a soft object into his mouth.

    If possible, turn the patient to one side during the seizure to allow secretions to drain and to prevent aspiration. Otherwise, do this at the end of the clonic phase when respirations return. (If they fail to return, check for airway obstruction and suction the patient if necessary. Cardiopulmonary resuscitation, intubation, and mechanical ventilation may be needed.)

    Protect the patient after the seizure by providing a safe area in which he can rest. As he awakens, reassure and reorient him. Check his vital signs and neurologic status. Be sure to carefully record these data and your observations during the seizure.

    If the seizure lasts longer than 4 minutes or if a second seizure occurs before full recovery from the first, suspect status epilepticus. Establish an airway, start an I.V. line, give supplemental oxygen, and begin cardiac monitoring. Draw blood for appropriate studies. Turn the patient on his side, with his head in a semi-dependent position, to drain secretions and prevent aspiration. Periodically turn him to the opposite side, check his arterial blood gas levels for hypoxemia, and administer oxygen by mask, increasing the flow rate if necessary. Administer diazepam or lorazepam by slow I.V. push, repeated two or three times at 10- to 20-minute intervals, to stop the seizures. If the patient isn’t known to have epilepsy, an I.V. bolus of dextrose 50% (50 ml) with thiamine (100 mg) may be ordered. Dextrose may stop the seizures if the patient has hypoglycemia. If his thiamine level is low, also give thiamine to guard against further damage.

    If the patient is intubated, expect to insert a nasogastric (NG) tube to prevent vomiting and aspiration. Be aware that if the patient hasn’t been intubated, the NG tube itself can trigger the gag reflex and cause vomiting. Be sure to record your observations and the intervals between seizures.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Seizures, simple partial: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    After the seizure, instruct the patient to record his seizures. Also, emphasize the importance of complying with the prescribed drug regimen and maintaining a safe environment.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Seizures, absence: Patient counseling
    (Professional Guide to Signs & Symptoms (Fifth Edition))

    Explain the purpose of any diagnostic tests, such as computed tomography scans, magnetic resonance imaging, and EEGs. Teach the patient and his family about these seizures and how to recognize their onset, pattern, and duration. Include the child’s teacher and school nurse in the teaching process, if possible. If the seizures are being controlled with drug therapy, emphasize the importance of strict compliance.

    » READ BOOK EXCERPT ONLINE »

    Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

    Carpopedal spasm: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Prepare the patient for laboratory tests, such as complete blood count and serum calcium, phosphorus, and parathyroid hormone studies.

    Carpopedal spasm can cause severe pain and anxiety; provide a quiet, dark environment to help the patient remain calm. Observe him closely for other signs of hypocalcemia until laboratory results rule out the disorder.

    Patient teaching

    Advise the patient to report numbness, tingling, or pain during hospitalization. If he has a disease that increases his risk of low serum calcium level, emphasize the need for dietary calcium replacement upon discharge from the hospital. Teach the patient the importance of receiving immunization against tetanus and keeping a vaccination record. If his immunization status is uncertain, he must receive the vaccine. Tetanus toxoid booster shots must be given every 10 years after the initial immunization.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Fasciculations: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Prepare the patient for diagnostic studies, such as spinal X-rays, myelography, computed tomography scan, magnetic resonance imaging, and electromyography (EMG) with nerve conduction velocity tests. Prepare the patient for laboratory tests such as serum electrolyte levels. Help the patient with progressive neuromuscular degeneration to cope with activities of daily living, and provide appropriate assistive devices.

    Patient teaching

    Teach the patient with stress-induced fasciculations effective stress management techniques. Refer him to physical therapy, occupational therapy, or home care services, as indicated.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Level of consciousness, decreased: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Reassess the patient’s LOC and neurologic status at least hourly. Carefully monitor ICP and intake and output. Ensure airway patency and proper nutrition. Take precautions to help ensure the patient’s safety. Keep him on bed rest with the side rails up and maintain seizure precautions. Keep emergency resuscitation equipment at the patient’s bedside. Prepare the patient for a computed tomography scan of the head, magnetic resonance imaging of the brain, EEG, and lumbar puncture. Maintain an elevation of the head of the bed to at least 30 degrees. Don’t administer an opioid or sedative because either may further decrease the patient’s LOC and hinder an accurate, meaningful neurologic examination. Apply restraints only if necessary because their use may increase his agitation and confusion. Talk to the patient even if he appears comatose; your voice may help reorient him to reality.

    Patient teaching

    Explain the treatments and procedures the patient needs. Teach safety and seizure precautions. Provide referrals to sources of support. Discuss quality of life issues with the patient and his family, as indicated.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Myoclonus: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    If your patient’s myoclonus is progressive, institute seizure precautions. Keep oral airway and suction equipment at his bedside, and pad the side rails of the bed. As needed, administer drugs that suppress myoclonus: ethosuximide, L-5-hydroxytryptophan, phenobarbital, clonazepam, or carbidopa. An electroencephalogram may be needed to evaluate myoclonus and related brain activity.

    Because myoclonus may cause falls, remove potentially harmful objects from the patient’s environment, and remain with him while he walks. Be sure to instruct the patient and his family about the need for safety precautions in the home.

    Patient teaching

    Inform the patient about safety measures and seizure precautions. Discuss the importance of following the prescribed medication regimen and the need for drug level monitoring, as indicated. Refer him to social service or community resources, if appropriate.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Seizures, generalized tonic-clonic: Nursing considerations
    (Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

    Closely monitor the patient for recurring seizure activity. Prepare him for a computed tomography scan or magnetic resonance imaging and EEG. Monitor therapeutic drug levels. Provide a safe environment and institute seizure precautions. Continue to monitor the patient’s vital signs and respiratory status. Provide supplemental oxygen, as indicated.

    Patient teaching

    Advise the patient’s family to observe and record his seizure activity to ensure proper treatment. Emphasize the importance of strict compliance with the drug regimen and warn the patient about its possible adverse effects. Stress the importance of regular follow-up appointments for blood studies. Provide information on alcohol or drug cessation programs if the seizure was related to withdrawal or abuse.

    » READ BOOK EXCERPT ONLINE »

    Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007

    Carpopedal spasm: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    If you detect carpopedal spasm, quickly examine the patient for signs of respiratory distress (laryngospasm, stridor, loud crowing noises, cyanosis) or cardiac arrhythmias, which indicate hypocalcemia. Obtain blood samples for electrolyte analysis (especially calcium), and perform an electrocardiogram. Connect the patient to a monitor to watch for the appearance of arrhythmias. Administer an I.V. calcium preparation, and provide emergency respiratory and cardiac support. If calcium infusion doesn’t control seizures, administer a sedative, such as chloral hydrate or phenobarbital.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Chorea: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Teach the patient and his family safety measures to reduce the risk of falls and poisoning. Discuss genetic counseling if Huntington’s disease is the cause of the patient’s chorea because each child of a parent with the disease has a 50% chance of inheriting it.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Level of consciousness, decreased: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    After evaluating the patient’s airway, breathing, and circulation, use the Glasgow Coma Scale to quickly determine his LOC and to obtain baseline data. (See Glasgow Coma Scale.) Insert an artificial airway, elevate the head of the bed 30 degrees and, if spinal cord injury has been ruled out, turn the patient’s head to the side. Prepare to suction the patient, if necessary. You may need to hyperventilate him to reduce carbon dioxide levels and decrease intracranial pressure (ICP). Then determine the rate, rhythm, and depth of spontaneous respirations. Support his breathing with a handheld resuscitation bag if necessary. If the patient’s Glasgow Coma Scale score is 7 or lower, intubation and resuscitation may be necessary. Continue to monitor the patient’s vital signs, being alert for signs of increasing ICP, such as bradycardia and widening pulse pressure. When his airway, breathing, and circulation are stabilized, perform a neurologic examination.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Myoclonus: Emergency Actions
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    If you observe myoclonus, check for seizure activity. Take vital signs to rule out arrhythmias or a blocked airway. Have resuscitation equipment on hand. If the patient has a seizure, gently help him lie down. Place a pillow or a rolled-up towel under his head to prevent concussion. Loosen any constrictive clothing, especially around the neck, and turn his head (gently, if possible) to one side to prevent airway occlusion or aspiration of secretions.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Seizures, generalized tonic-clonic: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Advise the patient’s family to observe and record his seizure activity to ensure proper treatment. Emphasize the importance of strict compliance with the drug regimen, and warn the patient about adverse reactions. Also, stress the importance of regular follow-up appointments for blood studies.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Seizures, simple partial: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    After the seizure, instruct the patient to record his seizures. Also, emphasize the importance of complying with the prescribed drug regimen and maintaining a safe environment.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Seizures, complex partial: Patient counseling
    (Signs & Symptoms: A 2-in-1 Reference for Nurses)

    Offer emotional support to the patient and his family. Teach them how to cope with seizures. Discuss safety measures to take during a seizure.

    » READ BOOK EXCERPT ONLINE »

    Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

    Carpopedal spasm: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ If carpopedal spasm causes severe pain and anxiety, leading to hyperventilation, help the patient slow his breathing through your relaxing touch, reassuring attitude, and clear directions about what he should do.

    ▪ Provide a quiet, dark environment to reduce his anxiety.

    ▪ Prepare the patient for laboratory tests, such as complete blood count and serum calcium, phosphorus, and parathyroid hormone studies.

    ▪ Suspect tetanus in anyone with carpopedal spasm, difficulty swallowing, and seizures.

    Patient teaching

    ▪ Explain the underlying disorder and treatment plan.

    ▪ Teach the patient the importance of receiving immunization against tetanus and of keeping a vaccination record.

    ▪ Explain that a tetanus toxoid booster shot should be given every 10 years prophylactically, after the patient has been properly immunized in childhood.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Fasciculations: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Prepare the patient for diagnostic studies, such as spinal X-rays, myelography, a computed tomography scan, magnetic resonance imaging, and electromyography with nerve conduction velocity tests.

    ▪ Prepare the patient for laboratory tests such as serum electrolyte levels.

    ▪ Help the patient with progressive neuromuscular degeneration to cope with activities of daily living.

    Patient teaching

    ▪ Teach the patient how to use assistive devices.

    ▪ Teach him about his underlying disorder, its progression, and treatment.

    ▪ Refer him to support groups, as indicated.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Level of consciousness, decreased: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Reassess the patient's LOC and neurologic status at least hourly.

    ▪ Carefully monitor ICP and intake and output.

    ▪ Ensure airway patency and proper nutrition.

    ▪ Keep the patient on bed rest and maintain seizure precautions.

    ▪ Keep emergency resuscitation equipment at the patient's bedside.

    ▪ Prepare the patient for a computed tomography scan of the head, magnetic resonance imaging of the brain, EEG, and lumbar puncture.

    ▪ Elevate the head of the bed to at least 30 degrees.

    ▪ Don't administer an opioid or sedative because either may further decrease the patient's LOC and hinder an accurate, meaningful neurologic examination.

    ▪ Talk to the patient even if he appears comatose; your voice may help reorient him to reality.

    Patient teaching

    ▪ Explain the underlying cause of decreased LOC and its treatments and procedures to the patient and his family.

    ▪ Teach them about safety and seizure precautions.

    ▪ Provide referrals to sources of support.

    ▪ Discuss quality of life issues, if appropriate.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Myoclonus: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ If the patient's myoclonus is progressive, institute seizure precautions.

    ▪ Keep an oral airway and suction equipment at his bedside, and pad the bed's side rails.

    ▪ Because myoclonus may cause falls, remove potentially harmful objects from the patient's environment, and remain with him while he walks.

    ▪ As needed, administer drugs that suppress myoclonus: ethosuximide, L-5-hydroxytryptophan, phenobarbital, clonazepam, or carbidopa.

    ▪ Prepare the patient for an electroencephalogram, as indicated, to evaluate myoclonus and related brain activity.

    Patient teaching

    ▪ Instruct the patient and his family about the need for safety precautions.

    ▪ Talk with the patient and family about seizure precautions.

    ▪ Refer the patient to social service or community resources, as needed.

    ▪ Explain the cause of myoclonic movement and the treatment plan.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Seizures, generalized tonic-clonic: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Institute seizure precautions.

    ▪ Closely monitor the patient after the seizure for recurring seizure activity.

    ▪ Prepare him for a computed tomography scan or magnetic resonance imaging and EEG.

    ▪ Administer anticonvulsants, as ordered, and monitor drug levels.

    Patient teaching

    ▪ Explain the disorder and treatment plan.

    ▪ Teach the family how to observe and record seizure activity.

    ▪ Emphasize the importance of compliance with drug therapy and follow-up appointments.

    ▪ Tell the patient to carry medical identification.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Seizures, simple partial: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Institute seizure precautions.

    ▪ Stay with the patient during seizure activity and reassure him.

    ▪ Monitor neurologic status.

    ▪ Prepare the patient for such diagnostic tests as a computed tomography scan and EEG.

    Patient teaching

    ▪ Explain the disorder and treatment plan.

    ▪ Explain that no emergency care is necessary during a focal seizure, unless it progresses to a generalized seizure. (See “Seizures, generalized tonic-clonic,” page 552.)

    ▪ Teach the family how to record seizures.

    ▪ Tell the patient to carry medical identification.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Seizures, absence: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ Administer an anticonvulsant, as ordered.

    ▪ Assess neurologic status, noting episodes of possible absence seizures.

    Patient teaching

    ▪ Teach the patient and family about the condition and its treatments.

    ▪ Explain signs and symptoms that require immediate attention.

    ▪ Emphasize the importance of follow-up medical care.

    ▪ Discuss the need to wear medical identification.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007

    Seizures, complex partial: Nursing considerations
    (Nursing: Interpreting Signs and Symptoms)

    ▪ After the seizure, remain with the patient to reorient him to his surroundings and to protect him from injury.

    ▪ Keep the patient in bed until he's fully alert, and remove harmful objects from the area.

    ▪ Prepare the patient for diagnostic tests, such as EEG, computed tomography scan, or magnetic resonance imaging.

    Patient teaching

    ▪ Explain the disorder and its treatment.

    ▪ Offer emotional support to the patient and his family, and teach them how to cope with seizures.

    ▪ Discuss with the patient and his family safety measures to take during a seizure.

    ▪ Emphasize compliance with drug therapy.

    ▪ Stress the importance of carrying medical identification.

    » READ BOOK EXCERPT ONLINE »

    Source: Nursing: Interpreting Signs and Symptoms, 2007



     » Next page: Doctors and Medical Specialists for Petit mal seizures

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