NUR 300 Nursing Transition

1: What should the nurse include in the patient and family teaching  about the new diagnosis of epilepsy?

2:  To assure safe medication administration when administering anti-seizure medications, list four (4) medications that could cause “name confusion” due to similarities in labeling.  Give the trade name (capitalized), the generic name (not capitalized), and the classification of the medication.

3: The nurse is responsible for patients receiving drugs for treatment of generalized seizures.List 3 “Assessment: History and Examination” bullet items; 3 “Nursing Diagnoses”; 3 “Implementation with Rationale”; and 3 “Evaluations” the nurse should include to begin the plan of care.

1.Newly diagnosed epilepsy needs proper patient and family teaching that would help to manage newly diagnosed seizure regarding the entire description of the seizure. The teaching is required in key areas like lifestyle activities, medications, management of seizure and in the case of emergency. Peter and his family needs to be provided with proper knowledge and education about the epilepsy especially that would relate to his specific diagnosis and treatment plan. They need to be informed about the medications of epilepsy and its related side effects, prevention, safety, injury and common psychological problems related with epilepsy (Miller, Bakas & Buelow, 2014).

Peter and his family needs to be informed how to manage the epileptic seizure at home by modifying the lifestyle and daily activities. For the patient education, Peter should avoid stress and take plenty of sleep. He should not lock the bathroom and take showers. He should not be engaged in any kind of physical activity that involves loss of consciousness like jogging, aerobics, bowling, tennis and golf. He should wear a helmet while riding, cycling or any other similar activities. He should also keep his epileptic medicines with him all the time along with a medical alert bracelet that will alert the people around him about his epileptic disorder. He should adopt relaxation techniques and avoid alcohol as it may interfere with the functioning of the anti-epileptic medicines (Ridsdale et al., 2017).

Apart from Peter, his family also needs to be trained while dealing with Peter’s epilepsy. Peter’s family should help him and make sure that he is protected from any kind of injury. They should have the emergency number if they have to call for help. Most importantly, they should be taught how to manage Peter when the seizure starts. His family should take proper care to avoid him from falling and help him to take him to a safer area and do not panic (Carson & Chapieski, 2016). He should be worn loose clothes with cushioning of head and monitor his pulse and breathing rate as they are considered to be the vital signs. They should also protect him from getting injured and turn him on one side in order to avoid vomiting. In case of an epileptic seizure, they should not give him anything to eat until his seizure stops and should not restrain him. They should call for emergency as Peter is having is newly diagnosed with a seizure. If the seizure persists after 5minutes, they should call for emergency. Moreover, they should try to manage his stress as he works in a hospital. They should keep in contact with his doctor and create a care plan with his healthcare provider (O'Toole et al., 2015).

2.

3.Before the nursing plan of care, the nurse should address the key areas like medical history and examination of Peter, nursing diagnosis, rational and implementation along with evaluations of the plan.

“Assessment: History and Examination”

• Firstly, Peter should be assessed for any kind of cautions or contradictions to avoid any kind of allergy or hypersensitivity reactions.
• A brief description of Peter’s seizures including the onset, duration, aura and recovery that helps to determine the type of seizure that he is suffering and establish a baseline for his treatment.
• A physical assessment is important that include the baseline data to determine the effectiveness of the prescribed therapy and to look for any kind of side effects or adverse potential effect of his prescribed anti-epileptic drugs (Fong et al., 2016).

“Nursing Diagnoses”

The nursing diagnosis is important as it is important to address the complications and diagnosis related to the drug therapy. The deficient knowledge regarding the drug therapy should also be addressed in nursing diagnosis.

• There is requirement of assessment of the acute discomfort that is related to the gastrointestinal tract and central nervous system.
• Disturbed thought processes that are related to central nervous system effects and impaired skin integrity that is related to the dermatological effects.
• The nursing diagnosis also includes the injury that is related to central nervous system effects or toxic drug levels (Karch & Karch, 2008).

“Implementation with Rationale”

The implementation of rationale include the key points like side effects of the epileptic drugs, hematological tests, adverse side effects, monitoring of drug interactions, counseling, patient and parent teaching.

• The patient and parent teaching is important that includes the drugs, their dosage, monitoring of adverse potential side effects and possible ways to enhance the patient teaching and education regarding seizures. The periodic complete blood count results to evaluate the drug levels and blood counts are also important to evaluate the effectiveness of the therapeutics of Peter.
• To look for any kind of allergy or hypersensitivity that might be caused due to the side effects or adverse reactions of the drug with the food. The drug might irritate the gastrointestinal tract so proper administration is required to prevent teh adverse potential effects of the drugs.
• The monitoring of drug-drug interaction is also required to arrange the adjustment of doses that might be added or withdrawn from the prescribed drugs due to adverse potential side effects (Lehne & Rosenthal, 2014).

“Evaluations”

The evaluation plan comprises of the monitoring of the response of the patient with the adverse effects of the prescribed medications and effectiveness of the drug therapy.

• Firstly, the patient should be monitored. In the given case study, Peter needs to be continuously monitored for the drug response. There are certain parameters needs to be addressed in Peter for evaluation. The incidence, absence or presence of seizures, with serum drug levels, blood levels and to ensure the appropriateness of the drug.
• Secondly, he should be monitored for any kind of adverse effects that might affect his central nervous system causing change and other parameters like rise in blood pressure, urinary retention, liver toxicity or bone marrow suppression.
• Thirdly, the effectiveness of the teaching plan needs to be monitored to make the patient aware of the adverse effects and ways to prevent them. He should also be educated about the information about his diagnosis and prescribed drug (Ignatavicius & Workman, 2015).

References

Carson, A. M., & Chapieski, L. (2016). Social functioning in pediatric epilepsy reported by parents and teachers: Contributions of medically related variables, verbal skills, and parental anxiety. Epilepsy & Behavior, 62, 57-61.

Fong, C. Y., Kong, A. N., Adnan, A., Southivongnorath, C., Mohamed, A. R., Ramli, N. F., & Lua, P. L. (2016). Raising attitude, knowledge and awareness of epilepsy using Interactive Animated Epilepsy Education Programme among parents, teachers and students in Kuala Lumpur, Malaysia. Developmental Medicine & Child Neurology, 58, 37.

Ignatavicius, D. D., & Workman, M. L. (2015). Medical-surgical nursing: Patient-centered collaborative care. Elsevier Health Sciences.

Karch, A. M., & Karch. (2008). Focus on nursing pharmacology. Philadelphia PA: Lippincott Williams & Wilkins.

Lehne, R. A., & Rosenthal, L. (2014). Pharmacology for nursing care. Elsevier Health Sciences.

Miller, W. R., Bakas, T., & Buelow, J. M. (2014). Problems, needs, and useful strategies in older adults self-managing epilepsy: Implications for patient education and future intervention programs. Epilepsy & Behavior, 31, 25-30.

O'Toole, S., Benson, A., Lambert, V., Gallagher, P., Shahwan, A., & Austin, J. K. (2015). Family communication in the context of pediatric epilepsy: a systematic review. Epilepsy & Behavior, 51, 225-239.

Ridsdale, L., Philpott, S. J., Krooupa, A. M., & Morgan, M. (2017). People with epilepsy obtain added value from education in groups: results of a qualitative study. European journal of neurology.