Initial assessments that the nurse should make include monitoring the patient’s vital signs such as cardiac rhythm and blood pressure. The nurse should also evaluate hygiene, urinary habits, nutritional health and the patient’s skin health. Additionally, an assessment of the patient’s strength, range of motion, and capacity for activities of daily living is necessary. Patient’s safety is crucial, so fall safety measures must be put in place, and his residence must be examined for potential safety concerns. Information about the patient’s use of any over-the-counter drugs or vitamins should be noted. The presences of several conditions make it necessary to assess all areas of risk for the patient.
The patient’s family should be educated on the value of following dosage instructions and taking antiepileptic medicines on schedule to maintain therapeutic blood levels and maximize effectiveness. Moreover, inform the family that the patient may develop an Anticonvulsant Hypersensitivity Syndrome primarily associated with phenytoin (Ghannam et al., 2017). In that scenario, it is necessary to regularly monitor his blood levels of the medication to change the dosage or treatment. Educating the family that the antiepileptic medication can decrease its effectiveness and lead to a rise in seizures (Löscher & Klein, 2021) is very essential. Inform the family; therefore, to maintain scheduled appointments with a physician to check on serum levels because of the risk of drug decline and sensitivity.
It is important to position the patient in the lowest position possible and also take off any potentially constricting clothing. Move any potentially dangerous items away from the patient. Since it is crucial to keep the airway open during a seizure, the nurse will need to suction any secretions he may have in his mouth.
It is vital to note when the seizure started and when it ended. A record is required to detail the patient’s vital signs and neurological examination. During the seizure, the nurse should look for loss of consciousness, alteration in pupil dilation, eye blinking, and the presence of airway obstruction, or salivation. Maintaining a record of the incident is important for future references in nursing management as well as in offering training to the family.
Home nursing is a very integral part in patient care and should be approached with great care and concern for the patient. Because the patient suffers from several conditions that make it nearly impossible to be independent, the family should be made more aware of necessary care services.
References
Ghannam, M., Mansour, S., Nabulsi, A., & Abdoh, Q. (2017). Anticonvulsant hypersensitivity syndrome after phenytoin administration in an adolescent patient: A case report and review of literature. Clinical and Molecular Allergy, 15(1).
Löscher, W., & Klein, P. (2021). The pharmacology and clinical efficacy of antiseizure medications: from bromide salts to cenobamate and beyond. CNS Drugs, 35(9), 935–963.