Question

Unit 6 Discussion

You will have multiple components to the discussion that will need to be answered. You may answer these items in a list with the number by them in the initial discussion. First post is due by Wednesday and requires two credible references. You must reply to two of your peers and the final post is due by Sunday. You must participate on a minimum of two different days when posting. Your replies should be based on differences in your answers from another person’s. It is alright to disagree with a peer as long as the post is respectful. There is more than one right answer to many of the questions.

*Initial post is due by Friday, April 17, and the final post (the two replies to two different students) is due by Sunday, April 19.

Part #1: Use the following story to complete the questions below:

You are the nurse on a medical unit taking care of a 50-year-old man, Allen, who was admitted 18 hours ago with peptic ulcer disease secondary to suspected chronic alcoholism. You enter Allen’s room and find him having violent generalized convulsion all over and his foaming out his mouth with cyanotic lips.

The rapid response team is called, and the provider gives the orders shown in the chart.

Medication Administration Record

Thiamine 100 mg IM now
50% glucose, 1 50-mL IV bolus now
Lorazepam 4 mg IM now

You accompany Allen as the rapid response team transfers him to the ICU. During the transport, his seizure activity ceases.

1. What type of seizure do you believe Allen is having and why?
2. What do you believe caused the seizure?
3. What are 3 priority nursing actions when caring for a patient having this type of seizure?
4. What is the purpose of the lorazepam and thiamine ordered and was the lorazepam drawn up correct for administration?
5. Using SBAR, what information will you provide to the ICU nurse?

Situation:

Background:

Assessment:

Recommendation:

Part #2 of the Discussion—

6. Post an overview of a topic discussed within this unit or compare and contrast topics covered within this unit, excluding seizures (could be vision, hearing, head injuries, etc.) Within this posting list 2 multiple choice questions with four choices related to your topic.
7. Answer one other student's 2 posted questions. Provide rationale for the answer and the source (including page numbers) to support your answer to each question.
8. The student who posted the question from Part A must provide feedback to the student and include an expansion of the rationale if needed. If the question is incorrect, provide the student with an explanation to the incorrect answers.

Answer 1

Status epileptics is a type of generalized seizures. It is mainly seen in patients with chronic alcoholism or alcohol withdrawal .

Here patient is admitted with peptic ulcer. H. pylori can cause an individual to have a vitamin B12 deficiency. It is also a known contributor to the peptic ulcer and it can prevent to the stomach from being able to absorb the vitamin B12(thiamine).thiamine deficiency is the main reason behind this patients seizure activity.

Action of lorazepam in seizure activity :

Lorazepam is a type of benzodiazepine, that affects nerve signaling in the brain. It works by enhancing the effect of an inhibitory neurotransmitter or cell signaling molecule called gamma-aminobutyric acid(GABA). GABA works to reduce the excitability of neurons, in effect “turning down” the signal emitted by nerve cells and decreasing the output nerve signal.thus it reduces the seizure activity .

Action of Thiamine in seizure :

Thiamine serve as a cofactor for several enzyme involved in brain function and neurotransmitter biosynthesis. It's deficiency leads to wernicke-korsakoff syndrome, cerebellar degeneration and cardiovascular dysfunction. Thiamine administration in seizure control this.

Lorazepam dose is 0.1-0.15mg/kg up to 4-6mg over 1-2 mts. Lorazepam administration route is INTRAVENOUS.

Nursing actions:

Check the saturation level of patient and adminiter oxygen .

Check the vital signs of the patient.

Immediately put an intra venous cannula and give prescribed medication.

Shift the patient to the intensive care unit.

Situation :now admitted with peptic ulcer.

Background : chronic alcoholism

Assessment :while entering the room patient had violent generalized seizures with foaming out the mouth .Lips was chaotic.

Recommendation :thiamine 100mg,glucose50% and lorazepam administered.