Medical Surgical Seizures #8


A 21-year-old client diagnosed with a head injury that occurred playing football presents with three tonic-clonic seizures while in the emergency department. The client is talking and awake the following day and asks the nurse what caused him to have a seizure. The nurse provides which explanation as a primary cause of tonic-clonic seizures?


  1. Cardiac dysrhythmia
    • Rationale:

      This answer is not correct because cardiac dysrhythmias are not a frequent cause of seizures in adults. The electrical impulses associated with cardiac dysrhythmias are a problem with the rate and rhythm of the heart, whereas the electrical impulses associated with brain injury become imbalanced and can cause seizure activity.

  2. Congenital malformation in the brain.
    • Rationale:

      This answer is not correct because congenital malformations usually develop prior to or are present at birth. Seizures experienced due to congenital malformation usually occur while young and not suddenly following head injury as an adult.

  3. Head trauma.
    • Rationale:

      This answer is correct because one of the most common reasons for tonic-clonic seizures in adults is traumatic brain injury that may occur from accidents and other traumas. Sports-related concussions are very common in teenagers who play football. The more severe the head trauma, the higher the risk for seizures.

  4. Drug overdose.
    • Rationale:

      This answer is not correct because even though seizures may occur with drug withdrawal, they are not common among regular adult populations. There is also no indication in the question that the client has a drug history or any withdrawal symptoms. The most common reason for tonic-clonic seizures in adults is traumatic brain injury that may occur from accidents and other traumas.


Head trauma or traumatic brain injury (TBI) is any injury to the scalp, skull, or brain. This diagnosis can cause many symptoms physically, cognitively, and sensory-wise, including seizures.


Learning Outcomes

Traumatic brain injury (TBI) can induce tonic-clonic seizures, or grand mal seizures. This is an intense seizure that involves loss of consciousness and extreme muscle contractions with a postictal period to follow. When the nurse receives a client with head trauma, she needs to ensure the client’s safety and be expectant of seizure activity. Protecting the client with seizure activity from injury includes having airway and suction supplies near the bedside, keeping the bed in lowest position and padding the side rails of the bed. During a seizure, placing the client in the recovery position and monitoring the airway is necessary. After the seizure, document the length of the seizure and what happened during the seizure.

Test Taking Tip

Be careful to not read things into a question. Just because it is in the answer does not mean it is part of the original scenario.

Video Rationale