Seizures happen when the brain cells send out abnormal signals. When people have recurrent seizures it called a seizure disorder also known as Epilepsy. There are two general types of seizures; partial seizures and generalized seizures. Small partial seizures involve part of the brain. They symptoms include involuntary twitching of the muscles, changes in the vision, vertigo, and unusual taste and smells. The person does not lose consciousness. Complex partial seizures have the same symptoms but in addition the person will lose awareness for a time.
They may engage in repetitive behavior (like walking in a circle or rubbing their hands) or stare (Wikipedia 2011). Generalized seizures involve almost all or all of the brain. There are absence seizures (petit mal) where you may start or have brief loss of consciousness. Myoclonic seizures are when the person is very jerky and/or twitching on both sides. Symptoms of a Grand Mal seizure are loss of consciousness, shaking and twitching, and loss of control of the bladder. The person can have unusual feelings before the seizure occurs.
These types of seizures last 5-20 minutes and are the worst type to have (Merck 2011). “What actually causes seizures is unknown. The only thing that researchers have found is that the brain cells get over excited and fire abnormally. Things that may cause seizures to occur are; head injury, genes, dementia, injury to the brain before birth, some medical conditions, strokes, and heart attacks” (Ron Jock 2011). Epilepsy is usually controlled, but cannot be cured. Thirty percent of people with epilepsy do not have any control over their seizures even with the medications.
The other seventy percent have little to all (wide range) control over their seizures (University of Maryland Medical Center 2011). Some people may have Epilepsy as a child and “grow out” of it. As they get older they stop having seizures. For others, there are many different types of medications that will help with the severity or frequency of the seizures. Another way to help control Epilepsy is therapy. The goal of therapy is to stop the seizures, minimize the side effects (from not having to take meds), and to stop the seizures from coming back.
They teach you how to live life around this disorder. A surgery is available that can make you stop having seizures. They completed a study of people who chose to have the surgery. Over half of the people had still not had a seizure ten years after (Ron Jock 2011). Most people with seizure disorders chose to have the surgery because the outcome is good. As a nurse aide we are responsible to make many important observations when a seizure occurs. First, if we have a suspicion that someone is having a seizure, we call for help.
When the seizure occurs we watch the time that it starts and ends (to know how long it was), what body parts are involved, the severity of the seizure (how much shaking and twitching occurs), and if they vomit or lose control of the bladder. If they are twitching or shaking, we can try to move things away from them if it could cause harm. Never try to stick anything in the person’s mouth, including you figures. After the seizure is over we take vital signs and pay close attention of how they feel. When people who have seizure disorder are in the hospital, we have to record all their seizures.
We keep track of their vitals and report everything to the nurse. Normal vitals are; blood pressure is between 100/60-140/90 (systolic number/diastolic number). Pulse is between 60-100 beats per minute. Respirations are between 14- 20 breaths per minute. The patients temperature should be between 97. 6-99. 6 (orally) 98. 6-100. 6 (ear/rectal) or 96. 6-98. 6 (axillary). The pulse oximeter should read in between 92-100% (Lippincott 2011). The doctor usually has to run many tests on seizure patients, so we get them up and ready for the test.
Depending on where you work you may have to transport them to the testing site. If they fell or an injury occurred while having a seizure, we would have to care for that too. Seizure patients are a huge fall risk; most people do not know when a seizure will start. This means that they can fall any time. We have to be very cautious, especially when walking with them. They are never allowed to walk alone and every patient should have a gait belt on while walking and/or transferring. While out of bed all patients need non-slip socks or shoes on.
Another way to help prevent falls is to keep their room clean. We don’t want anything on the floor that they could slip or trip on, so we always need to check the floor to make sure it’s clean. If a seizure does occur while you’re walking with them, you want to use your knee and leg to try to catch them. Nursing aides should always use a gait belt, so we would use that gait belt to pull them to us and try to make them “sit” on our knee. If there is control over the person we can bring them from our knee to the floor and lye them down.
The aide would try to put them on their side to prevent choking, and try to cushion their head. Clothing can be loosened (if tight) to help open airways and they head can be tilted back slowly to ensure air way remains open. No one should ever restrict someone having a seizure. When they seizure patient is in bed, they should always have at least two side rails up. They should also have blankets and pillows around them at all times. This way if they have a seizure while in bed they can’t hit their head on any of the side rails. They will be held in bed by the rails so they don’t fall out.
Hospital beds should always be left at lowest position, so if a patient happens to fall out they don’t have a long way to the floor. Whenever a nursing assistant walks away from a bed, the bed has to be returned to the lowest position, we give the patient their call light and make sure they are not in need for anything. As a nurse aide we have an important role in a person with a seizure disorder. We have to keep close attention and make sure to report and record everything. Seizure Disorders are very serious things. We want to keep them safe at all times.
Carter, Pamela J. Lippincott’s Textbook For Nursing AssistantsA Humanistic Approach to Caregiving. 3rd ed. Lippincott, 2011. Print. “Epilepsy.” Wikipedia, the Free Encyclopedia. Web. 08 Nov. 2011. . Http://www.euronet.nl/~jonkr/, Ron Jonk-. “Seizure Disorders.” University of Maryland Medical Center | Home. Web. 08 Nov. 2011. . “Seizure Disorders: Merck Manual Home Edition.” THE MERCK MANUALS – Trusted Medical and Scientific Information. Web. 08 Nov. 2011.