Question

The nurse is caring for a 40-year old client. Initial Prenatal Clinic Visit

Intrauterine pregnancy at 13 weeks gestation is confirmed. The client's medical history includes epilepsy and migraine headache. Home medications are iamotrigine and butalbital-acetaminophen-caffeine. Client is alert and oriented to person, place, time, and situation. She response to questions quickly and follows directions appropriately. Client does not report any recent siezures and reports no difficulties with memory or cognition. Physical examination is normal. Vitals: T 98.8, P 76, RR 18, BP 131/76, O2 98%
Emergency Department 1 Week Later
The client is brought to the emergency department after losing consciousness and falling at home. The client reports that prior to the fall, she had blurred vision, tinnitus, and nausea. She is confused and does not remember the incident or how she arrived at the hospital. The client is slow to answer questions and follow directions. Pupils are equal and reactive to light. Normal sinus rhythm noted on ECG. Deep tendon reflexes are 2+ with no clonus present. Laceration on the lateral aspect of the tongue and small laceration on the forehead are present. Client was incontinent of urine during the incident. The nurse understand that the client is most likely experiencing _________________ (Eclampsia, A postictal state, a migraine headache, Orthostatic hypotension) and should anticipate a prescription for ________________ (Lamotrigine, An IV fluid blous, Magnesium sulfate, butalbital-acetaminophen-caffeine)

Answer 1

The client in question is experiencing a postictal state after a seizure, and the nurse should anticipate an IV fluid bolus to aid in recovery.

Step-by-step explanation:

The client is most likely experiencing a postictal state following a seizure, as indicated by the loss of consciousness, confusion, incontinence, and the fact that she does not recall the incident. This is common in individuals with epilepsy after a seizure. Given the client's medical history and presentation, and the fact that she is pregnant, it is important to avoid certain medications that could harm the fetus. The nurse should anticipate a prescription for an IV fluid bolus to address any potential dehydration or electrolyte imbalance that could have occurred during the seizure and to support the client's overall recovery postictally. Medications such as lamotrigine are usually continued as they are part of the client's ongoing management for epilepsy, but any adjustments would be made by the healthcare provider based on a thorough evaluation of the client's condition.