362
Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:
Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition
Name Date
Unit Position
Instructor/Evaluator: Position
SKILL 17-3Employing Seizure Precautions and
Seizure ManagementGoal:The patient remains free from injury related to seizure
disorder. Comments- Review the medical record and nursing plan of care for
conditions that would place the patient at risk for seizures.
Review the medical orders and the nursing plan of care for
orders for seizure precautions.
Seizure Precautions- Gather the necessary supplies and bring to the bedside
stand or overbed table. - Perform hand hygiene and put on PPE, if indicated.
- Identify the patient.
- Close curtains around bed and close the door to the room,
if possible. Explain what you are going to do and why you
are going to do it to the patient. - Place the bed in the lowest position with two to three side
rails elevated. Apply padding to side rails. - Attach oxygen apparatus to oxygen access in the wall at the
head of the bed. Place nasal cannula or mask equipment in
a location where it is easily reached if needed. - Attach suction apparatus to vacuum access in the wall at
the head of the bed. Place suction catheter, oral airway,
and resuscitation bag in a location where they are easily
reached if needed. - Remove PPE, if used. Perform hand hygiene.
Seizure Management- For patients with known seizures, be alert for the
occurrence of an aura, if known. If the patient reports
experiencing an aura, have the patient lie down. - Once a seizure begins, close curtains around bed and close
the door to the room, if possible. - If the patient is seated, ease the patient to the floor.
- Remove patient’s eyeglasses. Loosen any constricting cloth-
ing. Place something flat and soft, such as a folded blanket,
under the head. Push aside furniture or other objects in
area.
ExcellentSatisfactoryNeeds Practice