You are preparing to admit a patient with a seizure disorder. Which of the following actions can you delegate to LPN/LVN?
A. Complete admission assessment.
B. Place a padded tongue blade at the bedside.
C. Set up oxygen and suction equipment.
D. Pad the side rails before the patient arrives.
Correct Answer: C. Set up oxygen and suction equipment.
The LPN/LVN can set up the equipment for oxygen and suctioning. Supportive care with attention to airway, breathing, and circulation issues are vital. Clear communication between team members is essential since patients’ clinical status may abruptly change. Most patients will have a single, brief, uncomplicated event and return to full consciousness. Detection of any underlying cause of the seizure or seizures is important, so that appropriate therapy or counseling is available.
Option A: The RN should perform the complete initial assessment. There are many causes of seizures, but regardless of the cause, the basic initial treatment is similar. Seizure patients all require supportive care and assessment of airway, breathing, and circulation with appropriate interventions.
Option B: Tongue blades should not be at the bedside and should never be inserted into the patient’s mouth after a seizure begins. For patients with a prolonged seizure or continuing seizures, other interventions, including medications and critical care interventions, may be necessary. Communication and coordination with other health care providers are essential to optimize team response.
Option D: Padded side rails are controversial in terms of whether they actually provide safety and may embarrass the patient and family. Most generalized seizures terminate in less than five minutes and a seizure of longer duration or serial seizures without regaining full consciousness in between defines status epilepticus. Whether status epilepticus is from provoked causes or unprovoked causes, initial treatment is similar.
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