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HIPPOCRATES WROTE about epilep-
sy in 400 BC. Dispelling a prevailing
myth that seizures were the work of
evil spirits, he said that epilepsy was a
brain disorder. Over the centuries,
medical science has confirmed his
theory, yet some mysteries still
remain.
Seizures range from short and sub-
tle to dramatic and life-threatening.
Unpredictable, recurrent, and unpro-
voked seizuresepilepsycan take
an enormous toll on a persons
lifestyle. According to the National
Institute of Neurological Disorders
and Stroke, about 1 in 100 people in
the United States have experienced an
unprovoked seizure or been diag-
nosed with epilepsy.
1
You may be uncertain about how to
help someone whos having a seizure
or who has a diagnosed seizure disor-
der. In this article, Ill clarify your role
by exploring the various types of
seizures, explaining their significance,
and discussing how to care for patients
affected by this bewildering problem.
What is a seizure?
Functioning as the bodys control cen-
ter, the brain transmits electrical
impulses throughout the body. If an
abnormal stimulus in the central ner-
vous system (CNS) causes excessive
and chaotic electrical discharge from
neurons in the brain, temporary
changes in cerebral function alter
motor or autonomic function, con-
sciousness, or sensation. The victim is
having a seizure.
Seizure manifestations depend on
the area of the brain involved. Specific
phases have been identified:
aura: a phenomenon some people
experience that warns of full-blown
seizure activity. Its characterized by
certain changes, such as depression,
irritability, or an unusual sensation
such as smelling wood smoke. An aura
can occur hours or even days before a
seizure.
ictus: the period of seizure activity
postictus: the phase after the seizure
during which the patient may be con-
scious but confused and tired. The post-
ictal phase can last several minutes to
hours. The victim may become lethar-
gic and may not remember the seizure.
Someone who has two or more
unprovoked seizures because of a
chronic underlying condition has
epilepsy.
1
Although no cure is cur-
rently available, most people with
epilepsy can limit seizures with drugs
or a medical intervention.
How seizures begin
The pathophysiology of seizures
remains unclear, but we do know that
genetics plays a role in some cases.
Seizures can be idiopathic or acquired:
idiopathic. In approximately 75% of
all seizures, the cause isnt identified.
2
acquired. Possible causes include aci-
dosis, electrolyte imbalances, hypo-
glycemia (particularly related to type 1
diabetes), hypoxia, alcohol and drug
withdrawal, dehydration, systemic
lupus erythematosus, hypertension,
septicemia, tumors, and head trauma.
The age at which someone develops
seizures may provide clues to the
cause. A neonate having a seizure may
have a brain defect, a birth injury,
meningitis, hypoglycemia, or hypocal-
cemia. Seizures in children are com-
monly caused by febrile illness, lead
toxicity (lead encephalopathy), or
head trauma. Major causes in adults
include head trauma, alcohol with-
drawal, metabolic disorders, a brain
tumor, or a brain infection or inflam-
mation such as an abscess, meningitis,
or encephalitis.
Several nonepileptic conditions can
cause a series of paroxysmal events
that mimic an epileptic seizure, but
abnormal electrical discharges of CNS
neurons arent involved. Examples
include syncope, hyperventilation,
and pseudoseizures due to psycholog-
ical conditions including panic and
anxiety attacks. Differentiating
between epileptic and nonepileptic
seizure activity is essential to deter-
mine the appropriate treatment.
Seizures are classified as partial and
Taking
charge of
Learn what happens
when the brains
electric signals go awry
and
how you can help someone
plagued by the
disturbing effects.
By Mary Unruh Fagley, RN, MSN
s ei z ur e a c t i v i t y

generalized. (Tracing seizure activity
shows the difference between them.)
Partial seizurea one-sided event
Also known as a focal seizure, a partial
seizure involves an abnormal electrical
discharge in only one brain hemi-
sphere. A partial seizure is simple or
complex, depending on whether it
affects the patients consciousness.
During a simple partial seizure, the
patient remains conscious and fully
aware of whats happening, but she
cant control it. She may experience
jerking movement or localized pain in
various body parts or a feeling of dj
vu. Simple partial seizure activity can
progress to a complex or a secondary
generalized seizure.
A complex partial seizure indicates
impaired consciousness without loss of
consciousness. The patient appears
fully awake but cant understand whats
happening. She may display bizarre,
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2.0
ANCC/AACN
CONTACT HOURS
a c t i v i t y
A partial seizure
involves an abnormal
electrical discharge in
only one hemisphere of
the brain.
A generalized
seizure involves
widespread abnormal
electrical discharge
across the entire
cortex. If a partial
seizure spreads to
the opposite
hemisphere, it
becomes a secondary
generalized seizure.
Tracing seizure activity
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involuntary automatisms such as re-
arranging objects, moving in circles, or
repetitively smacking her lips or grunt-
ing. She wont respond to commands
or remember the seizure when it ends.
A complex partial seizure can originate
anywhere in the brain but typically
starts in the temporal or frontal lobe.
When a partial seizure spreads to
the other side of the brain, its known
as a secondary generalized seizure.
Generalized seizure
widespread activity
A generalized seizure involves wide-
spread abnormal electrical discharge
across the entire brain cortex. The
manifestations can range from violent
motor activity, as in a convulsive
seizure, to much less obvious signs.
A convulsive generalized seizure is
what most people picture when they
think of epilepsy. Also known as a
tonic-clonic or grand mal seizure, a con-
vulsive generalized seizure dramatical-
ly affects the patient and bystanders.
(See Protecting your patient during a
seizure for measures to keep her safe.)
Causing loss of consciousness, a con-
vulsive generalized seizure consists of
three phases.
1. The tonic phase usually lasts 10 to
30 seconds. During this period, the
voluntary muscles contract, so the
arms flex and the legs extend. The
patient may fall from a standing posi-
tion, or if shes lying down, her body
can tense into an awkward position.
She may make screaming or crying
sounds as her thoracic muscles con-
tract, and she may lose bladder or
bowel control. Even if her eyes are
open, shes unresponsive and unaware
of her environment.
2. The clonic phase follows, with
rapid, rhythmic muscle contraction
and relaxation that cause jerking in
various body parts. The jerking may be
limited to the patients fingers or may
involve her entire torso and extremi-
ties. She cant swallow, so saliva pools
in her mouth and causes frothing.
Secretions or relaxation of her tongue
may obstruct her airway. The clonic
phase seldom lasts longer than 2 min-
utes. The periods of relaxation typical-
ly lengthen until the seizure ends.
3. The postictal phase following a
tonic-clonic seizure lasts 30 minutes to
several hours, during which the patient
lies very still as her brain recovers from
the trauma. She may be confused,
drowsy, nauseated, and disoriented.
Febrile seizures, although a type of
convulsive generalized seizure, arent
related to epilepsy. Caused by a rapid
increase in temperature that isnt ade-
quately treated or doesnt respond to
treatment, febrile seizures are more
common in children from 6 months to
5 years old but also can affect adults.
Typically, the childs rectal temperature
is greater than 102 F (38.9 C). From
95% to 98% of children who have
febrile seizures recover fully and never
develop epilepsy.
1
A nonconvulsive generalized seizure
has less obvious manifestations than a
convulsive generalized seizure, so its
harder to recognize. Nonconvulsive
generalized seizures are classified as
absence, myoclonic, and atonic
seizures.
An absence (formerly called petit
mal) seizure is characterized by a brief
interruption in consciousness without
loss of postural control. This type of
seizure typically affects children and
doesnt occur after puberty. The child
may have many periods of staring, eye-
lid fluttering, or lip smacking lasting
up to 10 seconds each time, while her
awareness and alertness are impaired.
Unaware of whats happened, she
immediately returns to normal activity
when the seizure ends.
A teacher may be the first person to
notice absence seizures and send home
a note indicating that the child day-
dreams too much or appears to blank
out frequently; both are signs of
absence seizures. If absence seizures
continue into adulthood, they usually
progress into convulsive generalized
seizures.
A myoclonic seizure is a nonconvul-
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Protecting your patient during a seizure
Safety is a top priority. Remain calm and use these measures:

Summon help and be prepared to use basic life support or advanced car-
diovascular life support.

If the patient is sitting or standing, lower her to a bed or to the floor. Raise
the side rails on the bed. If necessary, use pads or cushions to protect her
head from the side rails or hard floor.

Place her on her side to prevent aspiration. Stay with her, but dont restrain
her or hold her down. Both of you could be injured.

Move objects such as I.V. poles to a safe distance to prevent injury.

Provide privacy if possible.

Dont put anything in her mouth. Forcing something into her mouth can
break her teeth and cause you to be bitten.

Observe her and let the seizure subside on its own, but be aware of the
potential for status epilepticus. If seizure activity doesnt subside, contact the
practitioner and follow prescribed orders. If the practitioner isnt available, call
the rapid response team.

Once the seizure is over, place the patient on her side in the rescue posi-
tion if shes breathing and has a pulse. Be prepared to administer oxygen and
medications as ordered.

Once the patient is awake and alert, assess her and provide reassurance.
Be sensitive and supportive to her and her family.

Prepare her for diagnostic testing as ordered after the seizure.

Document the events leading up to the seizure and the length and type of
seizure activity, including the body parts involved.

Investigate factors that may have precipitated the seizure, such as missed
doses of antiepileptic drug, illness, menstruation, or stress.
sive seizure triggered by environmental
factors, such as flashing lights, that
stimulate the CNS. Striking at any age,
myoclonic seizures generally dont
cause loss of consciousness. They com-
monly occur before sleep or after
awakening and are characterized by
sudden, sporadic jerking motions con-
fined to one area or muscle group.
A nonconvulsive atonic seizure is
also known as an akinetic or astatic
seizure. Commonly referred to as a
drop attack, an atonic seizure is char-
acterized by a sudden loss of postural
tone, possibly causing the person to
fall to the ground from a standing posi-
tion. The seizure usually lasts only a
few seconds; the person either doesnt
lose consciousness or regains it before
she hits the ground. Because sudden
falls increase the risk of head and neck
trauma, someone who has atonic
seizures may be advised to wear head
gear for protection. Atonic seizures
typically begin in childhood and com-
monly recur into adulthood.
The perils of status epilepticus
Status epilepticus is a potentially life-
threatening complication of epilepsy
identified by either of these criteria:
two or more consecutive seizures
without the patient regaining con-
sciousness between them
continuous seizure activity lasting 5
minutes or more.
1
Status epilepticus is a medical emer-
gency because it can compromise the
airway, leading to hypoxia. Suddenly
deprived of oxygen, neurons begin to
die, resulting in potentially permanent
brain damage. Although status epilep-
ticus can occur with any type of
seizure, its usually a complication of a
convulsive generalized seizure.
Pinpointing a diagnosis
A thorough medical history and physi-
cal exam are the first steps to determine
why someone had a seizure. When you
assess the patient, get detailed informa-
tion from her and her family or
bystanders about the seizure activity,
including events leading up to it, the
duration and type of seizure activity,
and what they experienced or wit-
nessed after the seizure ended. Other
important information includes perti-
nent earlier life events (such as head
trauma, stroke, and history of seizures),
family history of seizures, and use of
prescribed or recreational drugs.
A neurologist or other appropriate
practitioner should perform a neuro-
logic exam. Various diagnostic tests
can help pinpoint whether the patient
had a seizure and, if so, what caused it.
Blood work. Your patients initial
postseizure assessment should include
serum glucose and electrolyte and plas-
ma osmolality levels. Electrolyte imbal-
ances and other abnormalities, such as
hypoglycemia and a hyperosmolar
state, can both trigger and result from
seizures.
Assays of antiepileptic drugs
(AEDs). If your patient is taking a
medication such as phenobarbital to
manage seizures, checking her blood
level will determine whether its in the
therapeutic range. Subtherapeutic and
toxic levels fail to control epilepsy and
they can cause such adverse reactions
as gastrointestinal upset, headaches,
drowsiness, and confusion.
The practitioner may order liver
and renal function tests, thyroid stud-
ies, and arterial blood gases to moni-
tor for imbalances that could alter the
effects of AEDs. He may need to
address liver, renal, or thyroid prob-
lems and explore other reasons for a
subtherapeutic drug level, such as if
the patient isnt adhering to prescribed
therapy. The patients medication regi-
men may have to be changed if blood
studies show that current levels arent
in the therapeutic range.
Cardiac studies. Cardiac studies,
such as an electrocardiogram, can help
rule out other causes of seizure activity,
including dysrhythmias.
Imaging studies. Various studies can
detect structural abnormalities includ-
ing arteriovenous malformations and
brain tumors. In an emergency, a com-
puted tomography scan of the head is
preferred to detect intracranial prob-
lems because it can be done quickly,
but magnetic resonance imaging of the
brain is more sensitive and can detect
more subtle lesions.
An electroencephalogram (EEG).
Safe and painless, the EEG measures
electrical activity in the brain and is the
most reliable method of diagnosing
and localizing seizures. However, it
isnt foolproof. Performing an EEG
within 24 hours of a seizure is more
likely to show an abnormality, but
more than one EEG may be necessary
to detect seizure activity.
3
Observation. If the patient has a low
risk of recurrent seizures (based on
seizure type, EEG findings, and imag-
ing results), the practitioner may rec-
ommend observation at home. This is
a period of watch and wait to identi-
fy further seizure activity. The patient
may have to take special precautions,
including no driving. Certain states
have mandatory reporting of seizure
activity and suspend driving privileges
for a certain period afterward.
Methods to manage seizures
Most seizure activity is self-limiting.
Status epilepticus, however, warrants
immediate intervention, such as drug
therapy to terminate the seizure.
The goal of treatment for epilepsy is
to prevent seizures and improve quali-
ty of life without adverse reactions to
therapy. The patient will work with the
neurologist to decide which approach
is best for her. The available options
include therapy with AEDs, surgery,
and vagal nerve stimulation.
Medications dont cure the underly-
ing cause of seizures, but maintaining
blood levels of appropriate medication
within the therapeutic range common-
ly controls seizures with few adverse
reactions. Antiepileptic drugs decrease
the number of seizure episodes in two
ways:
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45
suppress activity of damaged neurons
to minimize electrical discharge
reduce responsiveness of neighboring
normal neurons to block the spread of
excessive electrical discharge to other
parts of the brain.
Whether a patient should start drug
therapy after an initial seizure is con-
troversial. The likelihood of developing
epilepsy is only about 30% and AEDs
can cause adverse reactions.
3
(See The
downside of drug therapy.) Starting
treatment with an AED is usually indi-
cated for patients whove had one gen-
eralized seizure with a high risk of
reoccurrence.
4
Considerations in choosing an AED
include its efficacy and adverse effects,
long-term safety, tolerability, medica-
tion interactions, expense, and effect
on the patients quality of life. Typically,
the patient starts AED therapy at a low
dose and the dose is increased until
seizure activity is adequately con-
trolled. Starting at a low dose reduces
the risk of adverse reactions and helps
prevent toxicity. If her seizures persist,
the dosage and timing may need to be
adjusted or the neurologist may add
another AED to her regimen.
Surgery may be an alternative for
some patients whose seizures arent
controlled with medication. It may be
most beneficial when seizures are trig-
gered by structural brain abnormalities
such as tumors, blood vessel malfor-
mations, and stroke-related injury.
Postoperative seizure control isnt guar-
anteed, so the patient and the neuro-
surgeon must carefully weigh the bene-
fits against the risks. Possible compli-
cations of brain surgery include infec-
tion, bleeding, and paralysis.
Two main surgical procedures are
used to manage epilepsy:
Resection, or resective surgery, is more
commonly used. The neurosurgeon
removes a portion of the temporal lobe
and small portions of the hippocampus
on the affected side.
Disconnection surgery involves cut-
ting through nerve pathways that let
seizures spread. This surgery is appro-
priate when seizures begin in an area of
the brain thats too critical to remove.
Vagal nerve stimulation is another
treatment option when epilepsy isnt
well controlled with medication. The
vagus nerve is part of the autonomic
nervous system, which controls invol-
untary body functions such as heart
rate. Implanting a device that sends
mild electrical pulses to the brain via
the vagus nerve prevents seizures by
stopping the spread of excessive dis-
charge of neurons in the brain.
Your patient may undergo implanta-
tion of a vagal nerve stimulator under
local anesthesia as an outpatient. The
surgeon will make an incision in her
left upper chest and implant a pro-
grammable pulse generator under the
skin. Through a second incision in her
neck, hell wrap the stimulator wire
around her vagus nerve.
Using a magnetic wand, the practi-
tioner programs the pulse generator
through the skin to send electric ener-
gy to the vagus nerve every few min-
utes. The patient also may learn to use
a magnet to activate the vagal nerve
stimulator if she has an aura. Every few
years shell need a minor surgical pro-
cedure to change the battery.
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The downside of drug therapy
Teach your patient about the drugs used to manage seizures in adults and their
possible adverse effects.
Drugs used as monotherapy

phenytoin (Dilantin): dizziness, ataxia, slurred speech, nystagmus, confusion,

gingival hyperplasia, nausea, vomiting

valproate (Depakote): ataxia, tremors, sedation, headache, asthenia, weight

gain, nausea, vomiting, anorexia

carbamazepine (Tegretol, Carbatrol): dizziness, vertigo, ataxia, nausea, vomiting

lamotrigine (Lamictal): drowsiness, diplopia, blurred vision, dizziness, headache,

ataxia, rhinitis, nausea, vomiting

phenobarbital (Luminal): drowsiness, sedation, confusion, rash

Adjunctive agents

ethosuximide (Zarontin): ataxia, lethargy, headache, allergic reaction, nausea,

vomiting, bone marrow suppression

methsuximide (Celontin): ataxia, drowsiness, dizziness, nausea, vomiting

clonazepam(Klonopin): drowsiness, ataxia, behavior disturbance, anorexia

topiramate (Topamax): fatigue, paresthesia, cognitive effects, ataxia, nervous-

ness, tremor, abnormal vision, nausea, anorexia

tiagabine (Gabatril): dizziness, asthenia, somnolence, nervousness, nausea

gabapentin (Neurontin): fatigue, sedation, dizziness, ataxia, nausea

primidone (Mysoline): drowsiness, ataxia, diplopia, nausea, vomiting

felbamate (Felbatol): insomnia, dizziness, sedation, headache, blurred vision,

weight gain, decreased appetite, anemia, liver failure

levetiracetam(Keppra): sedation, incoordination, leukopenia

zonisamide (Zonegran): sedation, dizziness, confusion, headache, anorexia

oxcarbazepine (Trileptal): tremors, ataxia, fatigue, dizziness, vertigo, diplopia,

headache, nausea, vomiting, abdominal pain

pregabalin (Lyrica): dizziness, somnolence, blurred vision, dry mouth, weight

gain, peripheral edema
Drugs to treat status epilepticus

lorazepam(Ativan): sedation, respiratory depression, hypertension

phenytoin (Dilantin): see above

fosphenytoin (Cerebyx): sedation, dizziness, ataxia, pruritus, tachycardia,

hypotension

phenobarbital (Luminal): see above

midazolam(Versed): oversedation, respiratory depression, nausea

propofol (Diprivan): hypotension, cardiac or respiratory arrest.

Sources: Hickey JV,
5
Nursing2006 Drug Handbook.
6
Teaching involves patient
and family
Seizures disrupt the lives of both the
patient and those around her, so edu-
cate them about epilepsy and the pre-
scribed treatment and offer emotional
support. For example, reassure them
that although a cure doesnt currently
exist, many options are available to
help her live a normal life. Cover the
following points:
Teach the family how to care for the
patient during a seizure.
Explain that the primary cause of
breakthrough seizures is failure to
take medication as prescribed. Stress
the importance of adhering to the
drug regimen, including taking the
medication at the same time each day,
exactly as prescribed. Also teach her
and her family what to do if she miss-
es a dose.
Point out that shell probably need
periodic blood work to monitor for
therapeutic drug levels. Emphasize the
importance of having the levels
checked as ordered to prevent toxicity
or breakthrough seizures.
Emphasize the importance of contin-
ued follow-up care with a practitioner
and of consulting him if shes thinking
of changing therapy for any reason,
including alternative therapies.
Teach the patient how to prevent
injury due to a seizure. Warn her
against working around hazardous
materials and equipment, driving,
working at heights, and swimming
until she follows up with a neurolo-
gist or primary care provider and her
condition is well controlled. Recom-
mend patient and family support
groups for additional help and make
sure she understands her states laws
on driving for someone with seizure
history.
Encourage your patient and her
family to ask questions and make sure
you have the resources available to
answer them. Document all your
teaching.
Protecting and teaching
Your understanding of seizures pre-
pares you to protect a patient during
a seizure and to teach her and her
family how to manage an age-old
problem.
REFERENCES
1. National Institute of Neurological Disorders
and Stroke. Seizures and epilepsy: Hope through
research. http://www.ninds.nih.gov/disorders/
epilepsy/detail_epilepsy.htm#79193109.
Accessed April 30, 2007.
2. Yamamoto L, Oldes E. Challenges in seizure
management. Topics in Emergency Medicine.
26(3):212-224, August 2004.
3. Nicholl JS. Seizures in the emergency depart-
ment. http://www.emedicine.com/neuro/
topic694.htm. Accessed July 19, 2006.
4. Dunn MJ, et al. Early management of adults
with an uncomplicated first generalised seizure.
Emergency Medicine Journal. 5(22):237-242,
February 2004.
5. Hickey JV. The Clinical Practice of Neurological
and Neurosurgical Nursing, 5th edition. Philadel-
phia, Pa., Lippincott Williams & Wilkins, 2002.
6. Nursing2006 Drug Handbook, 26th edition.
Philadelphia, Pa., Lippincott Williams & Wilkins,
2006.
RESOURCES
Gambrell M, Flynn N. Seizures 101.
Nursing2004. 34(8):36-41, August 2004.
Smith P, Cossburn M. Seizures: Assessment and
management in the emergency unit. Journal of
Royal College of Physicians. 4(2):118-122, March
2004.
Epilepsy.com. http://www.epilepsy.com.
Epilepsy Foundation. http://www.
epilepsyfoundation.org.
Web sites last accessed on August 6, 2007.
Mary Unruh Fagley is a staff nurse in the emergency
department at Christiana Care Health Systems in
Wilmington, Del.
The author has disclosed that she has no significant
relationship with or financial interest in any commer-
cial companies that pertain to this educational activity.
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1. An unusual sensation before a seizure is
known as
a. postictus. c. atonia.
b. an aura. d. ictus.
2. Which of the following is a partial seizure
involving an abnormal electrical discharge
in only one brain hemisphere?
a. absence c. myoclonic
b. focal d. atonic
3. Which statement correctly describes
someone having a complex partial seizure?
a. She loses consciousness.
b. Shes able to remember the seizure.
c. She can respond to commands.
d. She appears fully awake.
4. Which statement correctly describes a
convulsive generalized seizure?
a. It involves only one brain hemisphere.
b. It causes tonic-clonic movements.
c. It consists of two phases.
d. Its another name for status epilepticus.
5. Which postures are characteristic of the
tonic phase of a seizure?
a. arms flexed and legs extended
b. arms extended and legs flexed
c. arms and legs flexed
d. arms and legs extended
6. In an emergency, whats the preferred
imaging study to detect intracranial causes
of seizures?
a. carotid Doppler
b. CT scan of the head
c. magnetic resonance imaging of the brain
d. cerebral arteriogram
7. What statement about using EEG in diag-
nosis of seizures is correct?
a. Its painful but safe.
b. Its the most reliable method of localizing seizures.
c. Performing it within 48 hours of seizure activity is
best.
d. Its foolproof.
8. Which statement about treating status
epilepticus is correct?
a. Pharmaceutical intervention can stop the seizure.
b. Supportive therapy is sufficient.
c. Its self-limiting.
d. The patient needs immediate surgical intervention.
9. Which statement about antiepileptic
drugs is correct?
a. They cure the underlying cause of seizures.
b. They augment electrical activity of damaged
neurons.
c. They block excessive electrical discharges to other
parts of the brain.
d. They increase the responsiveness of neighboring
normal neurons.
10. Which statement about the vagal nerve
stimulator is correct?
a. It requires an extended hospital stay.
b. A portion of the vagus nerve is resected.
c. Its a treatment option for a patient whose epilepsy
isnt well controlled with medication.
d. The battery must be changed every 6 months.
11. Which drug used as monotherapy in
adults can cause gingival hyperplasia?
a. clonazepam (Klonopin)
b. gabapentin (Neurontin)
c. topiramate (Topamax)
d. phenytoin (Dilantin)
12. Which adjunctive agent used to manage
seizures in adults can cause leukopenia?
a. valproate (Depakote)
b. lamotrigine (Lamictal)
c. phenobarbital (Luminal)
d. levetiracetam (Keppra)
13. Which of the following is a common
cause of seizures in adults?
a. head injury c. lead toxicity
b. birth injury d. febrile illness
Taking charge of seizure activity
GENERAL PURPOSE To provide nurses with an overview of seizures. LEARNING OBJECTIVES After reading the preceding article and taking this test, you
should be able to: 1. Differentiate between partial and generalized seizures. 2. Identify available options to manage seizures. 3. Indicate major patient-
education points regarding seizures.
2.0
ANCC/AACN CONTACT HOURS
ENROLLMENT FORM Nursing2007, September, Taking charge of seizure activity
A. Registration Information:
Last name ____________________________ __ First name ________________________ MI _____
Address ____________________________________________________________________________
City _______________________________________ State _________________ ZIP ______________
Telephone ____________________ Fax ____________________ E-mail ______________________
Registration Deadline: September 30, 2009
Contact hours: 2.0 Pharmacology hours: 0.0 Fee: $19.95
K LPN K RN K CNS K NP K CRNA K CNM K other __________________
Job title _____________________________________ Specialty _______________________________
Type of facility ____________________________________ ___ Are you certified? K Yes K No
Certified by ___________________________________________________________________________
State of license (1) __________________________ ___ License # ______________________________
State of license (2) _____________________________ License # ______________________________
K Please fax my certificate to me.
K From time to time, we make our mailing list available to outside organizations to announce
special offers. Please check here if you do not wish us to release your name and address.
B. Test Answers: Darken one circle for your answer to each question.
a b c d
1. H H H H
2. H H H H
3. H H H H
4. H H H H
a b c d
5. H H H H
6. H H H H
7. H H H H
8. H H H H
a b c d
9. H H H H
10. H H H H
11. H H H H
12. H H H H
a b c d
13. H H H H
C. Course Evaluation*
1. Did this CE activity's learning objectives relate to its general purpose? K Yes K No
2. Was the journal home study format an effective way to present the material? K Yes K No
3. Was the content relevant to your nursing practice? K Yes K No
4. How long did it take you to complete this CE activity?___ hours___minutes
5. Suggestion for future topics __________________________________________________________
D. Two Easy Ways to Pay:
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K Charge my K Mastercard K Visa K American Express
Card # _____________________________________________ Exp. date __________________
Signature _______________________________________________________________________
*In accordance with the Iowa Board of Nursing administrative rules governing grievances, a copy of your evaluation of the CE offering may be submitted directly to the Iowa Board of Nursing.
N1707