A nurse is caring for a client who begins to have a generali… | MyMerci
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Use of Restraints/Safety Devices

A nurse is caring for a client who begins to have a generalized tonic-clonic seizure. Place the following nursing actions in the correct order.

Ordered Response

Choose your responses, then check the answer.

Stay with the client and call for help.
Position the client on their side.
Document the seizure duration and characteristics.
Protect the client's head from injury.
Loosen restrictive clothing.
Explanation
During a seizure, the nurse must first ensure safety by staying with the client and calling for help to activate the emergency response system. Next, protect the client's head from injury using a soft object. Then, loosen restrictive clothing to prevent injury and promote breathing. After that, position the client on their side to maintain a patent airway and prevent aspiration. Finally, after the seizure ends, document the seizure duration, characteristics, and client's response.
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For study reference only. Always follow current clinical guidelines and your institution’s protocols.