ATI Medical Surgical Adult Nursing

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Medications- Ceftriaxone (Rocephin) or cefotaxime (Claforan) in combination with vancocin (Vancomycin) [antibiotics until culture and sensitivity results are available], Phenytoin (Dilantin) [Anticon... vulsants if ICP increases or client experiences a seizure], Decadron (dexamethasone) [corticosteroid], Acetaminophen (Tylenol), ibuprofen (Motrin) [fever], Ciprofloxacin (Cipro), rifampin (Rifadin), or ceftriaxone (Rocephin) [prophylactic antibiotics]  Complications- Increased ICP (possibly to the point of brain herniation), SIADH, Septic embolileads to DIC or CVA Chapter 6- Seizures and Epilepsy  Seizures are abrupt, abnormal, excessive and uncontrolled electrical discharge of neurons within the brain that may cause alterations in the level of consciousness and/or changes in motor and sensory ability and/or behavior.  Epilepsy is the term used to define a syndrome characterized by chronic recurring abnormal brain electrical activity.  Causes- genetic predisposition, acute febrile state, head trauma, cerebral edema, abrupt cessation of antiepileptic meds, infection, metabolic disorder, exposure to toxins, brain tumor, hypoxia, acute drug/alcohol withdrawal, F&E imbalances o Generalized (tonic-clonic)- begins with tonic episode (stiffening) and loss of consciousness 1 to 2 min of clonic episode (jerking)breathing may stopbiting of cheek or tongue o Tonic- usually lasts 30 seconds to several minutes loss of consciousness less common alone o Clonic- lasts several minutesless common alone o Absence seizure- most common in children consists of a loss of consciousness lasting a few seconds associated with blank staring o Myoclonic- brief jerking or stiffening of the extremitieslasts for seconds o Atonic or akinetic- a few seconds in which muscle tone is lost followed by a period of confusion loss of muscle tone results in falling  Labs- alcohol and illicit drug levels, HIV testing, and, if suspected, screen for the presence of excessive toxins  Diagnostic- Electroencephalogram (EEG)records electrical activity and may identify the origin of seizure activity, MRI, CT, PET, CSF, skull x-ray  Interventions- protect from injury, turn on side to prevent aspiration, loosen restrictive clothing, do not restrain pt, do not open jaw or insert airway during  Medications- antiepileptic drugs (AED), such as phenytoin (Dilanti [Show More]

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