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Nursing and Focal Dyscognitive Seizures: A Clinical Update When Managing Risk Using Advanced Nursing Skills

Holland, Christine; Edward, Karen-leigh; Giandinoto, Jo-Ann

Journal of Neuroscience Nursing: June 2017 - Volume 49 - Issue 3 - p 164–168
doi: 10.1097/JNN.0000000000000276
Clinical Nursing Focus
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ABSTRACT Focal seizures are divided into simple and dyscognitive, with the latter resulting in the alteration of consciousness. In the ictal and postictal stages, patients may present with confusion, delirium, and psychosis, presenting a risk of safety to themselves and others. This article presents 3 case studies where patients have been admitted for visual and electroencephalographic monitoring. Seizure activity is provoked for the diagnosis and development of a management plan. These cases illustrate the unique nursing implications when caring for patients experiencing focal dyscognitive seizures, highlighting the unique circumstances for the neuroscience nurse regarding risk management, safe administration of radioactive isotopes, detection of subtle seizure manifestation, and use of family as experts in patient-centered care. Through a deliberate onset of seizures, neuroscience nurses are placed in nontypical nursing situations, thus managing risk in unpredictable conditions and displaying advanced and distinctive nursing skills.

Questions or comments about this article may be directed to Jo-Ann Giandinoto, BN(Hons) BBSc, at jo-ann.giandinoto@acu.edu.au. She is a Research Associate, Research Unit, Australian Catholic University, St Vincent’s Private Hospital Melbourne, Victoria, Australia.

Christine Holland, is Nurse Unit Manager, Neurosciences, St Vincent’s Private Hospital Melbourne, Victoria, Australia.

Karen-leigh Edward, PhD, is Associate Professor, Research Unit, Australian Catholic University, St Vincent’s Private Hospital Melbourne, Victoria, Australia.

The authors declare no conflicts of interest.

© 2017 American Association of Neuroscience Nurses