I cared for a 95 year old man who was in for asp pneumonia for the past 2 days. Yesterday he took a turn for the worst and became unresponsive. He also spiked a temp of 104.3 axillary. I gave him a tylenol supp. Later in the AM he had a tonic-clonic seizure that lasted about 1 minute. His vitals BP 50/48 Pulse 120, RR 32 (shallow) temp 100.0 A after the seizure. He ended up having about 7 more seizures t/o the day. Because he was a DNR, the family and doc decided there was nothing that could be done and to let him pass comforably in peace (he was in no pain). My question is why the seizures? What may have caused them? Did he have a stroke? I thought it may have been the high fever but after the first seizure his temp was only 100.0. Anyways, I am just a little confused and was wondering if anyone had any insight on why this happened. Thanks so much
Jan 6, '03
Hi, sounds like the guy was septic, did you take the temp rectally? Axillary temps aren't usually reliable. He still could've had a fever and you just weren't able to record it. do you know the wbc? that could also be an indicator of septicemia. People can have seizures from fever or any pressure or abnormal activivty in the brain from stroke to swelling.
Jan 8, '03
What were his electrolytes like, do you know? Can seize with a low Na+.