Discussion: Interpretation of Neurologic Issues in Clients with Special Considerations

Living with a chronic illness is something nearly everyone deals with at some point in their life. Chronic neurologic disease, such as living with a ventricular shunt due to hydrocephaly, epilepsy, or chronic migraines, can make some days unpredictable, but with stable daily management, most will have a day as typical as anyone else. It is usually only when there is an interruption to the daily routine, such as forgetting to take daily medications, that problems occur. You are participating in your local state fair by volunteering at the medical station. Toward the end of the day, a 21-year-old male is brought to you by his girlfriend. She explains “He started to act confused—not knowing where he was and how long he had been at the fair.” She knows that he has epilepsy, but she does not know what to do. The young man is talking and able to answer your questions. He is from a neighboring city, and he became confused about an hour ago while walking to one of the local 4-H cattle shows. He says he feels like he “lost time,” but he knows the correct day of the week, the month, and the year. He has normal vital signs, and he reports no history of head injury, nor of surgery. He has had the focal (partial) seizure problem since the age of 10, but it has been well controlled through medication. However, he thinks he forgot to take his medicine before leaving for the fair early that morning. You only note horizontal nystagmus during the physical exam, and afterwards he begins complaining that there is a strong burnt plastic smell. No one else in the medical tent notices this smell. He has had no alcohol today, and he does not drink socially. He wants to go home unassisted, rather than riding to the hospital in an ambulance. Navigate to the threaded discussion and respond to the following: Explain the special considerations, such as the symptoms in the scenario above, that nurses should be aware of when assessing the neurologic system, interpreting findings, and planning nursing care for clients. Based on your interpretation of your findings in the case scenario, write two priority nursing diagnoses for this client. One of the diagnoses should address safety and other should be the basis for a teaching plan the patient can take with him. Incorporate at least one scholarly, evidence-based resource to support your response. Include citations and references for sources using correct APA formatting. Share your personal experiences with the history taking, physical assessment, and interpretation of findings related to the neurologic system in clients with special considerations: What were the challenges? How did you overcome these challenges?