Jorge Alvarez is a 3-year-old boy who has been hospitalized following his seizure. Since being admitted 2 days ago he has experienced three subsequent tonic–clonic seizures lasting 2 to 2½ minutes...

Jorge Alvarez is a 3-year-old boy who has been hospitalized following his seizure. Since being admitted 2 days ago he has experienced three subsequent tonic–clonic seizures lasting 2 to 2½ minutes each. Prior to having a seizure Jorge notices a flash of light. He then loses consciousness, emits a hoarse cry, and has intense muscle contractions. During the clonic phase he is incontinent of bowel and bladder. His postictal phase is characterized by drowsiness, disorientation, and deep sleep. On admission Jorge was scheduled for a sleep-and-awake EEG. His EEG revealed a high-voltage spike discharge, which is diagnostic of a tonic–clonic seizure. The laboratory studies performed on Jorge included a serum led level to rule out lead intoxication and a serum glucose level to rule out hypoglycaemia. Both the lead level and blood glucose were in the normal range. Jorge has been started on the following medications to assist in controlling his tonic–clonic seizures: carbamazepine (Tegretol) 300 mg PO tid and phenytoin (Dilantin) 120 mg PO tid.

1. Jorge’s mother expresses concern about what to do if he has a seizure. Create a list of home safety tips that could be given to her.

2. What will you instruct Jorge’s mother with regard to his medication administration?