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Diagnostic procedures done:

I. Problem : Seizure disorderA. Complete Blood Count

Relevant Findings:

Elevated WBC count of 13.611x103/mm3 (N:4.5-11x103/mm3) Elevated Neutrophil count of82% (N:55-70%) Other components were found to be normal

Importance: To establish a baseline and identify infections, allergies, and other

abnormalities that may affect the choice of appropriate anticonvulsant medication(s)

and help to monitor the possible drug-induced side effects in the future.

B. Serum ElectrolytesRelevant Findings:

Slightly elevated Na levels of150 meq/L (N:135-145 meq/L) No findings in relation to serum osmolality, other components were

found normal

Importance: Serves as a screening test for electrolyte and acid base imbalances; since a

bifocal relationship can be expected with serum electrolytes such as Na in cases of

hypernatremia and hyponatremia with the occurrence of partial and general tonic-clonic

seizures.

C. Computed Tomography ScanResults:

No lesions were foundImportance: To detect space occupying lesions, intracranial bleeding, infarctions, or

cerebral edema affecting local or specific cerebral points contributing to seizure

characteristics.

Nursing considerations:

Assessment1. Seizure history2. Type of seizure3. Occurences before, during and after the seizure4. Prodromal signs, such as mood changes, irritability and insomnia

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5. Aura: a sensation that warns the client of an impending seizure6. Loss of motor activity or bowel and bladder function or loss of consciousness during the seizure7. Occurrences during the posticital stage, such as headache, loss of consciousness, sleepiness and

impaired speech or thinking

Nursing Interventions:1. Note the time and duration of the seizure.2. Assess the behavior at the onset of seizure.3. If the client is standing, place him or her on the floor and support the head and body.4. Maintain a patent airway (do not force the jaw open or place anything the clients mouth)5. Administer oxygen6. Prepare to suction fluids from the airway7. Turn the clients head to the side8. Prevent injury during the seizure do not insert tounge blade during tonic-clonic movements9. Remain with the client10.Do no restrain the client11.Loosen restrictive clothing12.Note the type, character and progression of movements during the seizure13.Monitor for incontinence14.Administer IV medications such as Diazepam (Valium), Phenytoin (Dilantin), and Phenobarbital

Sodium (Luminal) as prescribed to stop the seizure

15.Document the characteristics of the seizure16.Monitor behavior following the seizure, such as the state of consciousness, motor ability and

speech ability

17. Instruct the client about the importance of life-long medication and the need for follow-upmedication and blood level diagnostics.

18. Instruct the client to avoid alcohol, excessive stress and fatigue.