The spouse of a man being treated with sertraline (Zoloft) calls to report that he had a grand mal seizure. Prior to the seizure, he had seemed confused and his forehead felt hot. The man does not have a seizure-disorder history
Which action should the nurse direct the spouse to take? a. Monitor the patient and notify the clinic if there are more seizures.
b. Hold all medications and call 911 for transportation to the hospital.
c. Hold tonight's sertraline and encourage him to drink more fluids.
d. Administer an antipyretic drug to lower his fever and prevent seizures.
B
The client's seizure may be due to serotonin syndrome, a potentially life-threatening emergency that merits immediate evaluation. Monitoring for further seizures would delay the needed medical evaluation. Medications which increase serotonin activity should be held as a precaution, but drinking more fluids would not improve serotonin syndrome if present (nor most other potential causes of a seizure). Assuming the seizure was caused by his possible fever delays a full evaluation and is not necessarily supported by the available data.
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