INTRACRANIAL REGULATION – SeizuresOverview: This case requires knowledge of seizures, growth and development, as well as an understanding ofthe client’s background, personal situation, and parent-child relationship.Client ProfileBrent is a 9 year old school age child who lives with his parents and two siblings. Heattends middle school and achieves average performance. Last year Brent and his familywere involved in a motor vehicle accident in which Brent experienced a closed headinjury. He was hospitalized for 3 months and through therapy has regained his mobility,cognitive functioning, and most of his memory. During his recovery he experiencedseveral seizures and was prescribed phenytoin sodium 50 mg PO t.i.d. When he returnedto school, his parents informed the school nurse of Brent’s condition. Brent takes onedose of medication before school, one at lunchtime, and the last dose in the evening athome. This regimen has controlled his seizure activity.Case StudyThis afternoon at school, Brent experiences a seizure involving loss of consciousness,violent spasms, and stiffening with the upper extremities flexed and the lower extremitiesextended. His classroom teacher moved all the desks away from where Brent was havinghis seizure, placed a pillow under his head, and sent one of the other students in her classto bring the school nurse to the classroom. By the time the nurse arrived at the classroomabout 2 minutes later, Brent’s seizure was over and he was lying quietly on the floor. Thenurse was able to arouse him and sent the teacher to the office to call 911. His parentswere called, and he was transferred to the local acute care facility.Questions——————————————————————————————————————–1. Discuss the different types of seizures that affect children. 2. Discuss the possible relationship between Ben’s closed head injury and the developmentof seizures. 3. What assessment data would be helpful for the nurse to have to prepare Brent’s care planon admission? 4. Identify at least 3 nursing diagnoses for Brent on admission? 5. Brent’s phenytoin sodium level is 4 mcg/mL. Discuss this level and what actions thenurse should take as a result of this information. 6. Brent weighs 30 kg (66 lb) on admission. Following diagnostic testing, his health caseprovider increases Brent’s dosage of phenytoin sodium to 75 mg PO t.i.d. Discuss therationale for this change and whether this dose is within the safe dosage range. 7. What impact might Brent’s seizure condition have on his growth and development? 8. Discuss the teaching priorities for Brent and his parents as he prepares for discharge fromthe hospital.

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