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This Concept Map, created with IHMC CmapTools, has information related to: 2-20-08, Patient had an seizure at 1300 on 2-17. the seizure was witnessed by his wife. The patient lost consiousness with generalized motor activity ("shaking all over"), the seizure was isolated, the patient's post ictal state was confused. Prior to this the patient's last seizure was in february of '07. (he has had no further seizure activity durring his hospitalization) The patient's wife explainedthat the patient was a fairly heavy drinker of vodka (multiple shots per day). He recently stopped drinking vodka and tried to switch simply to drinking "a bit of wine." Since his admission he has become encephalopathic and appears to be withdrawing from alcohol. On the morning of 2-18 he was agitated, confused "climbing out of bed" anxious and combative. There was difficulty communicating because despite his long residency in the US in his confused state he was only responsive to Romanian. By 2-20 he was calm, cooperative, and communicating in english. THe patient also has rectal bleeding which he was being worked up by another doctor. (has not been observed durring this hospitalization) The patient was on dilantin at him but was non compliant with all his meds at home. (dilantin level on 2-18 was 1.1, therapeutic range 10.0-20.0) ???? Assessment, History of seizure disorder (x 10 years) noncomplient with meds at home, HTN, Depression, alcohol use (wine/vodka daily) ???? Home Meds, AS admitted 2-17-08 diagnosis: recurrent seizure, chronic rectal bleed ???? Social History, Knowledge deficit/risk for injury related to proper use of home medications as evidenced by patient's non compliance ???? ineffective coping/denial realted to addictive habbits (alcohol abuse, pack a day smoker) as evidenced by patient's actions and statement "nurse: how are you feeling? patient: I'd feel better if I could have a drink.", Patient had an seizure at 1300 on 2-17. the seizure was witnessed by his wife. The patient lost consiousness with generalized motor activity ("shaking all over"), the seizure was isolated, the patient's post ictal state was confused. Prior to this the patient's last seizure was in february of '07. (he has had no further seizure activity durring his hospitalization) The patient's wife explainedthat the patient was a fairly heavy drinker of vodka (multiple shots per day). He recently stopped drinking vodka and tried to switch simply to drinking "a bit of wine." Since his admission he has become encephalopathic and appears to be withdrawing from alcohol. On the morning of 2-18 he was agitated, confused "climbing out of bed" anxious and combative. There was difficulty communicating because despite his long residency in the US in his confused state he was only responsive to Romanian. By 2-20 he was calm, cooperative, and communicating in english. THe patient also has rectal bleeding which he was being worked up by another doctor. (has not been observed durring this hospitalization) The patient was on dilantin at him but was non compliant with all his meds at home. (dilantin level on 2-18 was 1.1, therapeutic range 10.0-20.0) ???? Disturbed Sensory Perception related alcohol withdrawal (delirium tremens) as evidenced by irritability, restlessness and visual hallucinations, Current Hospitalization ???? Falls risk, activity as tolerated regular diet, seizure protocol, DT protocol, AS admitted 2-17-08 diagnosis: recurrent seizure, chronic rectal bleed ???? Current Hospitalization, Disturbed Sensory Perception related alcohol withdrawal (delirium tremens) as evidenced by irritability, restlessness and visual hallucinations ???? Knowledge deficit/risk for injury related to proper use of home medications as evidenced by patient's non compliance, Patient had an seizure at 1300 on 2-17. the seizure was witnessed by his wife. The patient lost consiousness with generalized motor activity ("shaking all over"), the seizure was isolated, the patient's post ictal state was confused. Prior to this the patient's last seizure was in february of '07. (he has had no further seizure activity durring his hospitalization) The patient's wife explainedthat the patient was a fairly heavy drinker of vodka (multiple shots per day). He recently stopped drinking vodka and tried to switch simply to drinking "a bit of wine." Since his admission he has become encephalopathic and appears to be withdrawing from alcohol. On the morning of 2-18 he was agitated, confused "climbing out of bed" anxious and combative. There was difficulty communicating because despite his long residency in the US in his confused state he was only responsive to Romanian. By 2-20 he was calm, cooperative, and communicating in english. THe patient also has rectal bleeding which he was being worked up by another doctor. (has not been observed durring this hospitalization) The patient was on dilantin at him but was non compliant with all his meds at home. (dilantin level on 2-18 was 1.1, therapeutic range 10.0-20.0) ???? Current Meds, AS admitted 2-17-08 diagnosis: recurrent seizure, chronic rectal bleed ???? Medical History, Medical History ???? History of seizure disorder (x 10 years) noncomplient with meds at home, HTN, Depression, alcohol use (wine/vodka daily)