Question

Scenario: Cooper Madison, a 6-year-old Caucasian male, arrived atthe emergency department at 1045 Tuesday with a closed head injury and concussion, related to a fall from a tree house. A CT scan indicated possible skull fracture and subdural hematoma. A C-spine ruled out spinal fracture. While still in the emergency department, Cooper experienced an unwitnessed seizure. At 1300 Tuesday, Cooper was admitted to the pediatric unit. The scenariotakes place on Wednesday at 0645.

Questions for scenario: Will thumbs up for good response .

4. What are the three main phases of a seizure? Differentiate among these phase, and list clinical assessment findings you might

observe when a patient is having a seizure.

5. Describe the key nursing interventions for a patient experiencing an active seizure. Be sure to include applicable medications

and clinical considerations for a patient who presents with these signs and symptoms.

6. Given the patient’s NPO status, how could the patient’s nutritional status be monitored and maintained until his diet is

advanced?

Answer 1

4...1).Aura phase::: it is a small partial seizures happend after a big event.it takes few seconds to minutes before the occuring of actual seizures.patient cannot explain their feelings in this stage

Symptoms::tongue biting,staring of eyes,frigid body,jerking movements are fast,dyspnoea,pale skin,dysphagia,increased heart rate,swating,incontience of urine,etc.

2)Ictal phase:::it is the middle stage of seizure.when the first symptoms starts to the final satge of seizurs period is called ictal phase.

Symptoms::perceptional and thought changes,blurring visin,co nfusion,unconscious,dysphagia,inability to hear,etc.

3)postictal phase :::it occurs at the final stage after seizure and after aura and ictal phase.it is also called recovery period.this may take minutes to hours after the seizure.

Symptoms:anxiety,depression,mental confusion,worried,tired,loss of memory,nausea,perceptional changes,thirst,bone injuries etc.

5)Nursing intervention:

1,prevent from falling

2.seizure precautions to be started such as suctioning,raise bed rails,Ambu bag.

3.maintaining the airway of the patient to ease breathi g.

4.turn tbe patient left side to prevent aspiration

5.Monitor,assess and document the time,phase and type of seizure activity.

6.provide psychological support.

7.give information about the procedures to the family and patient to reduce anxiety.

8.assist the patient make seizure action plan to get better care in home environment.

9.tell him about the importance of taking medication and doing follow up

MEDICATION:::::

1.phenoytoin

2.phenobarbital.

3.Neurontin

4.carbamazepine.

6.Intravenous fluid should be administred in patient with seizure if he is NPO

Total parental nutrition also can give to the patient after checking the weight.