prevent or reduce seizures; providing education -Teach the importance of giving anti-convulsant therapy and its importance - Most COMMON cause of breakthrough seizures is NONCOMPLIANCE - Educate not only the child and family but also the community, including the child’s teachers
and caregivers How to Respond When Your Child Has a Seizure: Remain calm Time seizure episode Ease child to the ground if possible Lossen clothing around neck Do NOT restrain the child Remove hazards in the area Do not forcibly open jaw w/ a tongue blade or fingers Document length and movements noted during seizure Remain w/ child until fully conscious Call EMX if seizure last longer than 5 mins, 1 st seizure, stops breathing, an injury has occurred, and is unresponsive to painful stimuli Febrile What is it? -Most COMMON type of seizures seen during childhood -Affect less than 5 years of age - Peak incidence occurs b/w 18 and 24 months old -Most commonly seen in boys - Increased risk for children who have a family history or febrile seizures -Associated w/ FEVER usually r/t VIRAL ILLNESS -May indicate a serious underlying infectious disease such as meningitis or sepsis, but are mostly BENIGN Complications: 1. Status Epilepticus 2. Motor coordination deficits 3. Mental Retardation 4. Behavioral Problems Therapeutic Management - Treatment includes determination of the cause of the fever and interventions to control the fever -Do NOT recommend long-term or intermittent anti-convulsant therapy -Rectal DIAZEPAM has been show to be safe and effective -Intermittent anti-convulsants at the time of FEVER may be used in select groups of children Assessment -Core temperature that increases rapidly to 39 degrees C (102.2 degrees F) or higher - Usually presents as a generalized tonic-clonic seizure Last few seconds to 10 minutes Followed by brief postictal period of drowsiness - Simple febrile seizure generalized seizure Last less than 15 minutes Occurs once in a 24 hr period Accompanied by FEVER Risk Factors: 1. Young age at 1 st febrile seizure 2. Family History 3. High Fever -No evidence exists that febrile seizures cause structural damage or cognitive declines Nursing Management - Reassure parents of the benign nature of febrile seizures -Counsel parents on controlling fever -Teach how to keep a child safe during seizures -Provide instruction and demonstration on how to provide rectal diazepam at the onset of seizure -Reinforce any recurrent seizure activity will require prompt medical attention
Neonatal What is it? -Incidence of seizures is higher in the neonatal period than in any other group -Immature brain is more prone to seizure activity -Occur w/in the 1 st 4 weeks of life -Most COMMONLY seen w/in the 1 st 10 days Associated w/ underlying conditions: 1. Hypoxic-ischemic encephalopathy 2. Metabolic disorder ( hypoglycemia and hypocalcemia ) 3. Neonatal infections ( meningitis and encephalitis ) 4. Intracranial hemorrhage - May have adverse effect on neurodevelopment and predispose infant to: 1.
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