Epilepsy | Nursing School Lecture

In this video, we are diving into epilepsy. The signs and symptoms of it. How would you would care for a patient with epilepsy as their nurse? Now, I'm going to break it down into simple steps for you to follow so that you can finally understand really what's going on in a patient with epilepsy. Let's dive in. Hey there, friend. My name is Christina Rafano and I am the creator, creator of the nursing school show welcome where we help you get better grades and have more free time in nursing school. That is really what we are all about here. And today we are diving into epilepsy. We're going to go step by step through it so that you can really understand it and critically think about it for your nursing school exams. Alrighty, let's get started. All right, so a seizure happens when many neurons in the brain are all firing at the same time. Now, typically, they only fire when they need to relay a message. Like if you want to move your leg to walk, or if you want to talk or turn your head, or if you're thinking about something, those neurons will fire. But during a seizure, there are so many neurons that are activated all at once. It overwhelms the brain and sometimes also the body. Now, when all of those neurons are firing at the same time, it causes a seizure. Now, this is a one time event, but with epilepsy, the patient will have a history of two or more seizures. But if they are recurring, it's called epilepsy. So you may hear those two phrases used when referring to seizures. So let's go through what happens here during epilepsy. So like we said, normally neurons fire throughout the brain as they are needed. One neuron will pass a message to the next neuron through these chemicals. They are called neurotransmitters. And then that next neuron fires and then tells the next neuron and the next, and so on and so on. So the neurons are always talking to each other. Now, we do talk about what seizures are and how they work in another video. We'll put it right up here for you so you can click on that. But let's review quick here before, before we dive into epilepsy. Now, there's two types of neurons that we will discuss here. Excitatory neurons and inhibitory neurons. Those are really important for you to know for epilepsy. So excitatory neurons are the ones that pass the signal from one neuron to the next and then they cause that next neuron to keep the signal going. So in excitatory neurons, the message just keeps going from one neuron to the next. But if it hits an inhibitory neuron, then that neuron will stop the message right there, and then that message will not continue. The way they work is kind of like a game of red light. Green light is a really great way to put it. The message can keep running through the brain through those excitatory neurons until one of those inhibitory neurons says to stop. Now, this balance between excitatory and those inhibitory neurons is super important here. But during a seizure, there's something that really triggers this normal communication to stop working and break down. And two things can happen. Either those excitatory neurons get overly active, or the inhibitory neurons aren't active enough. So either the excitatory neurons just keep going and going, no matter if the inhibitory neurons are telling them to stop, or the inhibitory neurons aren't active enough, and they don't yell loud enough for the excitatory neurons to hear them say stop. So either way, those excitatory neurons will take over, and then they just keep firing and firing and firing all at the same time. Now, with epilepsy, these neuron misfirings, they happen more frequently. So since epilepsy is defined as two or more seizures, then we know that that balance between excitatory neurons and inhibitory neurons is not always present. So these seizures can continue to happen if the neurons are not properly balanced in that way. All right, so let's talk about the signs and the symptoms that you might see in a patient who has epilepsy and then experience. Experience these types of seizures. Now, we know that a seizure is a flood of that electrical and neuronal activity in the brain, and all of this electrical activity in the brain happening just all at once at the same time. Now, we do talk about this more in depth in that video on seizures like I talked about before. We'll put it up there for you. But let's talk through the different phases of a seizure and what it may look like and then what some of those symptoms might be so you can better understand it. So seizures have three main phases. The orifices, the ictal phase, and the post ictal phase of a seizure. And each of them have their own signs and symptoms to them. The first phase is that aura phase. Now, this is more of a warning that a seizure is about to happen. So patients may experience this phase differently. And some patients, actually, they don't even have this aura phase. So for them, their there may be just no warning at all that a seizure is going to happen. And in patients with epilepsy, if they do have an aura, they are usually very in tune with it and they know when a seizure is imminent or about to happen. Now, they may have a funny feeling, a smell or a funny taste or something. They may experience dizziness or numbness. They may have changes in their vision or visual or auditory hallucinations. And it could be that they have a, maybe a sense of fear or a sense of panic. They might get a headache or feel nauseous. So again, all patients who have epilepsy may experience this or a phase or warning sign. They're going to experience it differently. And some might not even have it. Then the second phase is the ictal or ichthys phase. Now, this is the actual seizure episode itself. It varies based on the type of seizure that the patient is having and based on the patient themselves how they experience it. But seizures usually last anywhere from 30 seconds to three to five minutes. And then epilepsy, remember, is defined as more than one seizure. So it can be any type of seizure. Again, now we dive into those different types of seizures in that video. So be sure to check it out if you are needing this information on the different kinds of seizures for your nursing exam. Now, if the seizure has lasted more than five minutes, or if the patient had more than one seizure within a five minute time period, but they didn't come back to consciousness in between those seizure episodes, then that is considered status epilepticus. And further emergency care should be followed then to help the seizure end. Now, status epilepticus is different from epilepsy in that there is trouble really breaking that single seizure. Epilepsy is when there are multiple seizures over time of any type. So this ictal phase is the phase where the actual seizure itself occurs. And the signs and symptoms, like we said, they will be different depending really on the type of seizure the patient is having. Now, the last phase of a seizure is the post ictal phase. Now, this is the phase immediately following immediately after that seizure episode. Now, it can last anywhere from a few minutes to days. So think of this phase phase as the brain is really just recovering. The patient might be unconscious and unresponsive at first or confused. Their pupils might be sluggish and they might have a headache and be very, very tired. They may have lost control of their bladder or their bowels. And then in patients with epilepsy, they typically will know how the experience, how they experience that postictal phase. And then they can tell you some Insight into their normal behavior following a seizure event. Right. Because they have had a seizure before. Now, it is also important to remember that patients who have epilepsy, they usually have a lower seizure threshold when they are sick or ill. So they are at a higher risk for seizures to occur. And then sometimes when we don't know what will trigger the seizure in the first place. So it is, it really varies by patient to patient. But being aware of any perhaps possible triggers for them or auras that they get that the patient with epilepsy might experience, that will be super, super helpful for you to know. So you should definitely ask them that if you're caring for a patient with epilepsy. All right, so we've learned what epilepsy is and now we have learned about what a seizure is. Of course, the differences between the two and what's happening inside the body and the brain with the patient, and then the signs and symptoms of them. But there are five main things that you need to assess for in a patient with epilepsy. You need to ask about their seizure history. Assessing and ensuring that their airway is open during a seizure, of course, making sure that they are safe, and tracking the start time and the end time and the duration of any seizure seizure. And then you will also want to find out more about the patient's specific type of seizures and any auras that they may experience, as well as what the actual seizure event entails, typically for them, and how they are in that post adult phase. Now, if the patient has had a history of seizures like epilepsy, you'll need to dive a little deeper into what type of seizure that they usually have. How they feel during the seizure, like if they're conscious, typically if they have jerking movements or if their muscles just go flaccid. How long do their seizures typically last? Do they have any warning signs that they could tell you about that the seizure might happen? The aura, right. Things like a headache, maybe nausea or changes in vision. How do they feel after a seizure in that postictal phase? Then you'll want to ask how long do they typically stay unconscious? If they can tell you, do they have a headache, are they usually confused afterwards, things like that. That's all what you're going to want to ask. It's all really important to help you judge and prepare if a seizure were to occur again with this patient. Now, if you are caring for a patient during a seizure, let's talk about what to do. So there's three main things, like we said, that you will need to assess for their airway, make sure the airway is clear, Safety and time. Your number one priority is always airway. So during a seizure, maintaining the patient's airway, making sure it is open should be your number one priority. And something that the NCLEX and all your instructors in nursing school, your nursing school exams they are going to love to test you on is that you never put anything in your patient's mouth during a seizure. So NCLEX and your nursing school exams are big huge on safety. So make sure that you understand how to keep your patients safe. So making sure any patients with epilepsy that you have have a safe place, a safety plan at home with precautions in place if needed to help protect them. The key things to remember is airway safety and the timing of the seizure. So like we said, your number one priority should be to ensure that their airway is open and clear and that they are safe. Then make sure that you are timing that seizure like we said, the start time, the end time and the duration. Now of course my friend, there are three more ways that I can help you in nursing school. Remember to download this Nursing School School Study checklist that we have for you. It's totally free. It'll walk you through how to study step by step. And be sure to check out our nursing school boxes that we have available for you. They are packed with resources to help you succeed in nursing school and study better for your classes and learn everything faster. And of course if you want me to come alongside your journey and hold your hand throughout your nursing school journey and do not miss out on joining the Nursing SOS Membership community when enrollment opens again. It's filled with step by step nursing lectures to really help you understand everything faster that you need to know for your exams. These like Med Surg, Fundamentals, Critical Care, OB Maternity. You are going to love it. The links to all of those things are down below in the description for you to check out all the details. If you liked this video, be sure to hit that like button. Leave a comment below to let me know that you loved it. As always, I love hearing from you. Share it with a friend who also is having an exam coming up on epilepsy or seizures. And of course subscribe and hit the bell so you never miss a video and click on one of these videos right over here so you can keep rocking nursing school. And as always my friend, go become the nurse that God created only you to be. And I'll see you next time right here on the Nursing School Show. Take care Bye. Bye.