A nurse teaches assistive personnel about providing hygiene for a client in traction. Which statement would the nurse include as part of the teaching about this client’s care?

Choice A reason: Stopping AEDs when seizures stop is incorrect, as it risks rebound seizures due to unopposed neuronal excitability. Most patients require long-term therapy to maintain seizure control, especially in chronic epilepsy, guided by neurological evaluation.
Choice B reason: AED therapy is often lifelong for chronic epilepsy, as seizures result from persistent neuronal hyperexcitability. Maintaining therapeutic drug levels prevents recurrence, as the underlying neurological predisposition remains, requiring continuous management to stabilize brain activity.
Choice C reason: Consistent dosing maintains steady-state AED levels, preventing subtherapeutic concentrations that could trigger seizures. Fluctuations in drug levels disrupt neuronal stabilization, increasing seizure risk, making adherence to dosing schedules critical for effective epilepsy control.
Choice D reason: Skipping doses due to adverse effects is dangerous, as it lowers AED levels, increasing seizure risk. Adverse effects should be managed by consulting the provider to adjust doses or switch medications, not by skipping doses.
Choice E reason: Abruptly discontinuing AEDs can cause rebound seizures due to sudden loss of neuronal stabilization, leading to excitotoxicity. Gradual tapering under medical supervision is required to minimize withdrawal-induced seizures, making this a critical teaching point.

Choice A reason: Guiding a child to the floor during a seizure is unsafe, as it risks injury to both the child and nurse due to uncontrolled movements. Leaving to get help abandons the child, increasing injury risk during the seizure’s tonic-clonic phase.
Choice B reason: Moving objects away from a child during a tonic-clonic seizure prevents injury from striking hard surfaces. Generalized seizures cause uncontrolled muscle contractions, increasing the risk of trauma. Ensuring a safe environment is a priority to minimize harm during the seizure event.
Choice C reason: Inserting a tongue blade, even padded, risks dental injury or airway obstruction, as jaw clenching is common in tonic-clonic seizures. Current guidelines advise against placing objects in the mouth, as it does not prevent tongue biting and may cause harm.
Choice D reason: Restraining a child during a seizure can cause fractures or soft tissue injury due to forceful muscle contractions. It also increases stress and hypoxia risk. Allowing the seizure to occur while ensuring safety is the recommended approach to minimize complications.