A nurse is assisting with collecting data from a 10-month-old in the emergency department.
The Correct Answer is []
Condition the Client Is Most Likely Experiencing:
Tonic-Clonic Seizures: The infant exhibited rhythmic shaking of arms and legs, unresponsiveness during the episode, and postictal sleep, all characteristic of tonic-clonic seizures. These seizures often involve loss of consciousness and rhythmic convulsions of extremities.
Actions to Take:
- Initiate Seizure Precautions: Safety is paramount during and after a seizure to prevent injury. Seizure precautions may include padding the bed rails, ensuring airway patency, and having suction equipment available.
- Keep infant NPO until they are fully awake and alert: Keeping the infant NPO (nothing by mouth) until they are fully awake and alert is crucial to prevent aspiration, which can occur if the infant is fed while still drowsy or lethargic after a seizure.
Parameters to Monitor:
- Level of Consciousness (LOC): Monitoring LOC helps assess the child’s neurological recovery post-seizure and detect worsening neurological status. Persistent lethargy or confusion could indicate prolonged postictal states or complications.
- Motor Ability: Monitoring motor ability is essential to assess for postictal paresis (e.g., Todd's paralysis) or other neurological deficits resulting from the seizure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.5"]
Explanation
Ordered dose: 1 mg
Available concentration: 2 mg/mL
Volumetoadminister= Ordered dose /Concentration
=1mg /2mg/ml
= 0.5ml
Correct Answer is A
Explanation
A. Aura: An aura is a subjective sensation experienced before a seizure, such as a strange smell, taste, or visual change. It can provide clues about the seizure's origin in the brain, often linked to the temporal lobe.
B. Blood Pressure 90/60: Blood pressure is an objective, measurable sign, not subjective data reported by the child.
C. Oxygenation on room air 97%: Oxygenation levels are objective and do not provide information about seizure origin.
D. Temperature 38 degrees Celsius: Temperature is objective and does not help localize the seizure's origin in the brain.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.