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Complete the admission assessment: This involves data collection and interpretation, which are nursing responsibilities and cannot be delegated to a UAP.

Explain the call system to the patient: Teaching and verifying understanding fall under the nurse’s role. UAPs should not be assigned tasks involving patient education.

Place a padded tongue blade on the wall above the patient’s bed: This reflects an outdated and unsafe practice. Nothing should be inserted into the mouth during a seizure, and padded tongue blades are not used in modern seizure precautions.

Focal seizures are confined to one side of the brain and remain focal in nature: While focal seizures begin in one hemisphere, they may spread and become generalized, so this statement is only partially true and not the key distinction.

Generalized seizures result in loss of consciousness whereas focal seizures do not: Some focal seizures do impair consciousness (focal impaired awareness seizures), so this is an oversimplification.

Generalized seizures result in temporary residual deficits during the postictal phase: Postictal deficits (e.g., Todd's paralysis) are more often associated with focal seizures, not generalized ones.

Atonic: These seizures involve sudden loss of muscle tone, leading to falls or head drops. They do not primarily involve staring spells.

Simple focal: These seizures involve localized brain activity and do not cause a loss of consciousness. Staring is not a typical feature.

Atypical absence: These may also involve staring but are longer in duration, have more pronounced changes in tone, and typically occur in children with developmental delays or cognitive impairments. The onset and resolution are less abrupt than in typical absence seizures.

Subclinical seizures: These are seizures without outward physical manifestations, often seen on EEG. While clinically important, they are not immediately life-threatening.

Myoclonic seizures: These involve brief, shock-like muscle jerks and are usually not fatal, though they may occur in epilepsy syndromes with serious outcomes.

Psychogenic seizures: Also called pseudoseizures, these are non-epileptic events typically related to psychological factors. They do not cause physiologic brain damage or death.

“So many factors can cause epilepsy that it is impossible to say what caused your seizure.”While partially true, this response is vague and dismissive, and may increase anxiety without offering useful information.

“Epilepsy is an inherited disorder. Does anyone else in your family have a seizure disorder?” This suggests a narrow cause (genetic) and may lead to unnecessary concern. Not all epilepsy is inherited.

“Scar tissue in the brain alters the chemical balance, creating uncontrolled electrical discharges.” This describes one potential cause (post-traumatic or post-surgical epilepsy), but it’s too specific and may not apply to this patient’s situation.

Identification of scar tissue that is able to be removed: While identifying a resectable focus (such as a lesion or scar tissue) is important, it is not the initial requirement. The failure of drug therapy comes first.

Development of toxic syndromes from long-term use of antiseizure drugs: This may prompt a change in medication but is not a direct indication for surgery.

The presence of symptoms of cerebral degeneration from repeated seizures: While chronic seizures can cause neurologic decline, cerebral degeneration is not a requirement or a typical indication for surgery. Surgical treatment aims to prevent further damage.

A daily seizure log: While helpful in tracking seizure frequency and medication effects, it is subjective and does not assess drug levels or toxicity directly.

Urine testing for drug levels: Urine levels are less reliable for monitoring therapeutic ranges and are not typically used for routine management of epilepsy.

Monthly electroencephalography (EEG): EEG measures electrical brain activity and can detect seizure patterns but is not used to monitor medication compliance or toxicity.

The patient should increase the dosage of the medication if stress is increased: Patients should never self-adjust their medication dose. This can cause toxicity or inadequate control. Any changes must be directed by a healthcare provider.

Most over-the-counter and prescription drugs are safe to take with antiseizure drugs: Many drug interactions can occur with AEDs. Patients should be advised to consult their provider before taking any new medications.

If gingival hypertrophy occurs, the drug should be stopped and the health care provider notified: Gingival hyperplasia is a known side effect of phenytoin, but the drug should not be stopped abruptly. Good oral hygiene and provider notification are appropriate, but discontinuation should be physician-directed.

Suction the patient before allowing him to rest: Suctioning should only be performed if there is evidence of airway obstruction, excess secretions, or vomiting. Routine suctioning without need is unnecessary and invasive.

Stimulate the patient to increase his level of consciousness: Stimulating a postictal patient is inappropriate and may increase agitation or confusion. The brain needs time to recover naturally.

Check the patient’s level of consciousness every 15 minutes for an hour: Frequent checks may disrupt needed rest. While initial monitoring is important, once the patient is stable and breathing well, letting them rest is the priority.

Managing the complicated drug regimen of seizure control: While medication adherence is important, most seizure regimens are not overly complex. Psychosocial issues often present a greater long-term challenge than drug management.

Adjusting to the very restricted lifestyle required by a diagnosis of epilepsy: Although some activity modifications (e.g., avoiding swimming alone, driving restrictions) may be necessary, many patients can lead full and active lives with proper control. The idea of a “very restricted lifestyle” is inaccurate and outdated.

Learning to minimize the effect of the condition in order to obtain employment: Employment concerns are valid, but this choice emphasizes concealment rather than support and adaptation. Addressing stigma directly is a more holistic and empowering approach.

Monitor the client’s vital signs: While important for ongoing assessment, vital signs should be taken after airway and positioning needs are addressed.

Reorient the client to the environment: Reorientation is necessary once the client regains full consciousness, but it is not the immediate priority.

Check the client for injuries: This should be done after ensuring the client is safe and stable, especially after the airway has been secured.