During an emergency where a second seizure follows a first, which intervention should the nurse implement first?

• A. Assess the client's vital signs.
• B. Obtain a serum phenytoin (Dilantin) level.
• C. Ensure suction equipment is at the bedside.
• D. Apply a cardiac telemetry monitor.

Answer: (C)

Protecting the airway is the immediate priority during a seizure emergency, especially when a second seizure follows the first. Seizures can cause loss of protective reflexes and raise the risk of aspiration from secretions or vomitus. Having suction equipment at the bedside allows rapid clearance of any secretions or vomitus, helping maintain a clear airway and adequate ventilation as the event unfolds. After ensuring suction is ready, the nurse should position the patient on the side to facilitate drainage, stay with them, and time the seizure while calling for help. While checking vital signs, obtaining a drug level, or setting up a telemetry monitor are important parts of ongoing care, they don’t address the immediate threat to breathing as quickly as having suction available to clear the airway.