A child has a seizure disorder. What test should be done to ...

[Metfan725]

A child has a seizure disorder. What test should be done to gather the most specific information about the type of seizure the child is having?
 
  a. Sleep study
  b. Skull radiography
  c. Serum electrolytes
  d. Electroencephalogra m (EEG)

Question 2

A child has been admitted with status epilepticus. An emergency medication has been ordered. What medication should the nurse expect to be prescribed?
 
  a. Lorazepam (Ativan)
  b. Phenytoin (Dilantin)
  c. Topiramate (Topamax)
  d. Ethosuximide (Zarontin)

[gstein359]

Answer to Question 1

ANS: D
An EEG is obtained for all children with seizures and is the most useful tool for evaluating a seizure disorder. The EEG confirms the presence of abnormal electrical discharges and provides information on the seizure type and the focus. The EEG is carried out under varying conditionswith the child asleep, awake, awake with provocative stimulation (flashing lights, noise), and hyperventilating. Stimulation may elicit abnormal electrical activity, which is recorded on the EEG. Various seizure types produce characteristic EEG patterns: high-voltage spike discharges are seen in tonic-clonic seizures, with abnormal patterns in the intervals between seizures; a three-per-second spike and wave pattern is observed in an absence seizure; and absence of electrical activity in an area suggests a large lesion, such as an abscess or subdural collection of fluid.

Answer to Question 2

ANS: A
For in-hospital management of status epilepticus, intravenous diazepam or lorazepam (Ativan) is the first-line drug of choice. Lorazepam is the preferred agent because of its rapid onset (25 minutes) and long half-life (1224 hours) with few side effects.