Topic: What should nurses do during pt's seizure? If a pt has seizure, and ativan is a PRN med. How should this med be given? IV push or IV. Anyone has such kinds of experience? thank you @枫下论坛 The Rolia Forum

What should nurses do during pt's seizure? If a pt has seizure, and ativan is a PRN med. How should this med be given? IV push or IV. Anyone has such kinds of experience? thank you -hutuyishi(糊涂一时); 2010-2-26 (#2922@57)

Adult. ATIVan, 2mg subligual, repeat after 4 hours if another seizure occurs. Don't touch body since touching stimulates body jerks during seizure attack. -ceng(gg); 2010-2-26 (#2924@57)

Thank you very much for your response. The thing is ..... -hutuyishi(糊涂一时); 2010-2-26 {533} (#2925@57)
during the seizure activity, can I put ativan into pt's mouth? I remember when a seizure acitivity happens, nothing should put into pt's mouth and suction should be prepared to keep airway open. I checked a nursing journal. It says we can administer ativan to stop the seizure when it happens. But it doesn't say by which way. If I give IV push, it definately can stop the seizure soon, but is that the best way to stop the seisure? How about minibag IV? If I give ativan subligual, usually, how long it takes to stop the seizure?

首先, 你要确定这病人是不是癫痫大发作. 作为护士, 给何种药物, 用何种途径都必须要有医生医嘱. 你的问题在于有没有医生医嘱? -bihan(dudu); 2010-2-28 {168} (#2936@57)
我相信, 如果在病人癫痫大发作的时候, 不能口腔给药, 也无法开通静脉渠道. 你说的对, 准备好一切抢救仪器, 尽量减少光线和声音的刺激, 把周围的障碍物移移开是护士当时能做的事情.
Yes, the order is PRN and IV. It dosen't say IV minibag or IV push. -hutuyishi(糊涂一时); 2010-3-1 (#2938@57)

For many Rts living in nursing home or at home they have a lot of routine, e.g. bowel routine, seizure attack routine and instruction. You can give prn medications based on your judgement and rt's condition. -ceng(gg); 2010-3-1 (#2940@57)
depends on your unit policy. check the hospital policy, the hospital should specify the iv push authority. -yongqi(咏琪); 2010-4-9 (#3050@57)

Hope this reply still helpfull.. -coiceco(可可); 2010-3-29 {2065} (#3018@57)
本文发表在 rolia.net 枫下论坛Definition: Status Epilepticus is defined as 30 minutes or so of continuous seizure activity or a series of seizures without return to full consciousness between seizures.
Medical Maangement:

Confirm that the client has a tonic-clonic Status Epilepticus that is prolonged or repetitive seizures have occurred.
IV medications per D/O: Benzodiazepines, Diazepam (Valium) Lorazepam (Ativan), Midazolam (Versed), Phenpbarbital, Phenytoin (Dilantin).
Assess client's airway & oxygenation - check blood gas level.
Carry out Neurologic screen/exam for focal intracranial lesion.
Laboratory test: serum electrolyte, BUN, sucrose, antiepileptic drug levels, toxic drug screen, CBC
MRI & CT Scan
Lumbar puncture to r/o infectious etiologies
EEG (electroencephalography) - to establish diagnosis of the condition
Nursing measures:

At 0 minute:
initiate systemic support of the airway
check B/P
begin nasal oxygen
monitor ECG & respiration
check temperature frequently
perform neurologic exam
send serum sample to the lab
start IV line with isotonic saline at low infusion rate (per D/O)
call Lab to start EEG (per D/O)
admin Ativan 0.1 to 0.15mg /kg (per D/O)

At 20-30 minutes, if seizures persist:
check temp
as per D/O: intubate, insert bladder catheter, start EEG, admin Phenobarb loading dose of 20mg/kg IV (100mg/min)
At 40-60 minutes, if seizures still persist:
Per D/O- Phenobarb @ 5mg/kg IV initial then IV push until seizure stopped
monitor EEG
continue to monitor and document V/S
document I & O
Patient Goal:

Maintain optimal physiological functioning and preventing psychological stress.
Keep client free of systemic complications eg. cardiac, respiration or renal failure, fluid & electrolyte imbalance, hyperpyrexia.
Outcome:

Client was managed medically and was free from any complications. Optimum nursing care was carried out and client will resume to his/her ADLs with assistance and monitoring at first until confident to do so.

Reference: HealHealthCareNow.org/StatusEpilepticus更多精彩文章及讨论，请光临枫下论坛 rolia.net