Pre-Brief Assignment  Jackson Weber is a 5-year-old Caucasian male

Pre-Brief Assignment 

Jackson Weber is a 5-year-old Caucasian male. He was diagnosed with generalized tonic-clonic seizures 2 years ago. Upon diagnosis, Jackson's neurologist started him on oral phenobarbital. Jackson has been seizure-free until last night, when his mother brought him to the emergency department following a 3-minute tonic-clonic seizure. She is a single mother and the sole source of financial support.

Jackson has not seen his neurologist in 15 months due to his mother's work schedule. Jackson was seen by his health care provider this morning and currently has an intravenous infusion in his left arm running D5 NS + 20 mEq KCl/L at 58 mL/hr.

He has been eating well, has urine output, and vital signs are stable. His pupils are equal and reactive to light. He can move all extremities equally. He is awake and alert and is watching cartoons. His mother is at the bedside.

1. What are some major health concerns for Jackson based off the above scenario?
2. Describe the assessment for Seizure disorder.
3. What components are in the history of Seizure disorder? What would be concerning?
4. What does tonic-clonic seizures, decerebrate and decorticate posturing mean? What does each definition mean in terms of the brain?
5. What is the therapeutic serum level of phenobarbital?
6. What is the sub therapeutic serum level of phenobarbital? What could this cause?
7. What is the toxic serum level of phenobarbital? What would some toxic symptoms look like?
8. What is the rational for ensuring patient safety during seizure activity?
9. What is a complete blood count (CBC) and a basic metabolic panel (BMP)?

Post-Simulation Assignment

1. Create an SBAR report for the actions that you did in the simulation. The SBAR is a powerful tool that is used to improve the effectiveness of communication between individuals. It is easy to use and can help your staff learn the key components needed to send a complete message! Here are the key components of the SBAR:
   1. Situation: Clearly and briefly define the situation
   2. Background: Provide clear, relevant background information that relates to the situation. In the example above, you should consider including the patient's diagnosis, the prescribing physicians, and the dates and dosages of the medications.
   3. Assessment: A statement of your professional conclusion.
   4. Recommendation: What do you need from this individual?

Create a concept map for the diagnosis of Seizure disorder. 

• Pathophysiology
• Medication
• Medical Interventions
• Nursing Interventions
• Nursing Considerations
• Pertinent Assessment Findings
• Patient Education

Please complete medication cards:

• D5 NS + 20 mEq KCl/L
• Phenobarbital PO
• Ativan PO and IM

Example of the Drug card expected:

Nitrofurantoin (Macrobid)

Class:  Urinary tract anti infective

Actions:  

Inhibits bacterial acetyl-CoA interference with carbohydrate metabolism.

Indications: Urinary tract infections caused by Escherichia coli, Klebsiella, Staphylococcus

Side Effects:  Dizziness, headache, drowsiness, peripheral neuropathy, chills confusion vertigo

Nursing Considerations:  Lab tests: Culture and Sensitivity of urine sample before treatment. After treatment serum BUN and Creatine.

Intake and Output, dysuria fever cloudy foul- smelling urine.