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Seizures Case Study (45 min)

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Ms. Cerulean is a 22  year old female admitted via EMS after a seizure witnessed by family members about 20 minutes ago. She has an IV in place.

Critical Thinking Check
Bloom's Taxonomy: Application

What initial nursing assessments need to be performed for Mr. Cerulean?

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Upon assessment, Ms. Cerulean is lethargic, localizes to pain, but does not follow commands. She is diaphoretic, and her vitals are stable.

Critical Thinking Check
Bloom's Taxonomy: Analysis

Why is the patient experiencing a decreased level of consciousness at this time?

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Critical Thinking Check
Bloom's Taxonomy: Comprehension

Suddenly, the patient begins jerking. Her muscles are cycling back and forth between tight contractions and rhythmic jerking. What is this called?

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What is/are your priority nursing action(s) at this time?

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What medication(s) would you expect to give to Ms. Cerulean?

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Per provider orders, you administer 2mg Ativan IV Push twice in 10 minutes. Ms. Cerulean continues to seize without ceasing. The provider determines that she needs to be intubated for airway protection. Per orders, you administer a loading dose of levetiracetam and fosphenytoin and the EEG technician is on the way to place the EEG electrodes.

Critical Thinking Check
Bloom's Taxonomy: Comprehension

What is the name of the condition Ms. Cerulean is in now?

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Critical Thinking Check
Bloom's Taxonomy: Comprehension

What is the purpose of the EEG?

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Ms. Cerulean is placed on a phenobarbital IV drip and additional doses of levetiracetam and fosphenytoin are administered q6h per provider orders. After 20 hours, the EEG finally begins to show decreased seizure activity.

Critical Thinking Check
Bloom's Taxonomy: Comprehension

What are the risks of a prolonged seizure?

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