Question

A nurse is caring for a client who is at 26 weeks of gestation and has epilepsy. The nurse enters the room and observes the client having a seizure. After turning the client's head to one side, which of the following actions should the nurse take immediately after the seizure?Option 1: Elevate the client's legs to promote blood flow.

Option 2: Administer oxygen via a nonrebreather mask.
Option 3: Insert an oropharyngeal airway to maintain an open airway.
Option 4: Document the details of the seizure episode for the medical record.

Answer 1

The nurse should insert an oropharyngeal airway to maintain an open airway immediately after the seizure. Documentation of the seizure episode should also be done for the medical record.

Step-by-step explanation:

When caring for a client who is experiencing a seizure, it is important to prioritize their safety and comfort. After turning the client's head to one side to prevent choking, the nurse should focus on maintaining an open airway and providing oxygen if necessary.

Therefore, the appropriate action for the nurse to take immediately after the seizure is Option 3: Insert an oropharyngeal airway to maintain an open airway. This will help ensure that the client can breathe properly and avoid any complications.

After providing initial care, the nurse should also document the details of the seizure episode for the medical record, which is Option 4.