Seizures (epilepsy) in Nursing – NCLEX review

Learn about the seizure for the NCLEX nurses. These include different types of seizure,, generalized vs focal (also called partial) seizures, and the different types and stages of seizures on this Seizures notes for nursing as NCLEX review

Seizure Nursing NCLEX video on Youtube

Seizures generally occur when abnormal and uncontrolled electrical signals are fired by millions and billions of neurons in the brain.

Types of Seizures:

1. Focal (Partial) Seizures
   • Simple Focal (no loss of consciousness)
     • Twitching, sensory changes (tingling, smells, déjà vu).
   • Complex Focal (altered awareness)
     • Blank staring, repetitive movements (lip-smacking, picking at clothes).
2. Generalized Seizures
   • Tonic-Clonic (Grand Mal)
     • Tonic phase: Stiffening (15–20 sec).
     • Clonic phase: Jerking (1–2 min).
     • Postictal phase: Fatigue, confusion, headache.
   • Absence (Petit Mal)
     • Brief staring spells (5–10 sec), common in children.
   • Atonic (“Drop Attacks”)
     • Sudden loss of muscle tone (falls, head drops).
   • Myoclonic
     • Quick, jerking movements (like being shocked).

Common Causes:

• Epilepsy
• Fever (Febrile seizures in kids)
• Hypoglycemia
• Electrolyte imbalances (Na⁺, Ca²⁺)
• Brain injury, stroke, tumor
• Drug/alcohol withdrawal

Generalized seizure types

tonic-clonic seizures (formerly known as grand mal seizures),

• petit mal seizures,
• absence seizures,
• myoclonic seizures,
• tonic seizures, and
• clonic seizures.

Focal seizure(formerly called partial seizures)

Focal seizures include the following:

• focal onset aware seizures (also called simple partial seizures)
• focal impaired awareness (also called complex partial seizures).

These Seizures can occur in anyone (children and adults) due to a severe acute condition, like when there is high fever, illness (especially central nervous system types), hypoglycemia, acidosis, alcohol withdrawal, etc.

These seizures stop. Once the condition is corrected,

What is epilepsy?

Epilepsy is when a patient experiences frequent episodes of seizure activity due to a chronic condition. This can be from a massive stroke, traumatic brain injury, congenital defect, effects of a central nervous system infection,n etc.

you can also find the seizure and epilepsy on Nepal Nursing License Exam Syllabus

#seizures#epilepsy#seizuresnclex

Nursing Interventions:

During a Seizure:

1. Stay calm, time the seizure.
2. Protect from injury (move objects, pillow under head).
3. Do NOT restrain or put anything in the mouth.
4. Turn to side (recovery position) to prevent aspiration.
5. Administer O₂ if needed (postictal hypoxia).

After a Seizure:

1. Check vitals, LOC, and injuries.
2. Reorient the patient (postictal confusion).
3. Document:
   • Duration, type of movements, triggers.
   • Incontinence, tongue biting.

Medications (Antiepileptics):

• First-line: Phenytoin (Dilantin), Valproic Acid, Levetiracetam (Keppra).
• Nursing Considerations:
  • Monitor drug levels (therapeutic range).
  • Phenytoin: Gum hyperplasia, IV incompatibility.
  • Valproic Acid: Liver toxicity, thrombocytopenia.

Patient Education:

• Avoid triggers (flashing lights, stress, lack of sleep).
• Take meds consistently (sudden withdrawal → status epilepticus).
• No driving until seizure-free (state laws vary).
• Wear medical alert bracelet.

Emergency Alert:

Status Epilepticus (seizure >5 mins or recurrent without recovery):

• Medical emergency! → Give IV Lorazepam (Ativan) or Diazepam (Valium).
• Prepare for intubation (respiratory depression risk).