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Such convulsions occur without any underlying brain or spinal cord infection or other neurologicalcause. According to studies, about 3-5% of otherwise healthy children between the ages of 9 months and 5 years will have a seizure caused by a fever. Toddlers are most commonly affected. Most occur well within the first 24 hours of an illness, not necessarily when the fever is highest. The first febrile seizure is one of life’s most frightening moments for parents. Most parents are afraid that their child will die or have brain damage. Thankfully, simple febrile seizures are harmless. There is no evidence that simple febrile seizures cause death, brain damage, mental retardation, a decrease in IQ, or learning difficulties. (www.nlm.com) However, a very small percentage of children go on to develop other seizure disorders such as epilepsy later in life. See all our nursing care plans here
Benign Febrile Convulsion is a convulsion triggered by a rise in body temperature. Fever is not an illness and is an important part of the body’s defense against infection. Antigens or microorganisms cause inflammation and the release of pyrogens which is a substance that induces fever.
Assessmen Nursing t Diagnosis
Nursing Rationale Interventions >Assess underlying condition and body temperature. >Monitor and recorded vital signs.
Subjective Hyperthermia Short term: : After 4 hours Ө of nursing interventions, the patient’s Objective: temperature will decrease the patient from 39°C to manifested normal range : of 36.5°C to 37°C. > febrile temp = Long Term: 39°C >flushed skin and warm to touch > convulsion > RR = 34 bpm the patient may manifest:
>To obtain Short term: baseline date. The patient’s >To note for temperature progress and shall have evaluate effects decreased ofhyperthermia. from 39°C to normal range >To decrease or of 36.5°C to totally diminish 37°C. >Remove pain. unnecessary Long Term: clothing that >Reduces could only metabolic The patient aggravate demands or shall have After 2 days heat. oxygen. been able to of nursing be free of interventions, >Promote >To promote complications the patient adequate rest surface cooling. and maintain will be able to periods. core be free of temperature >To help complications >Provide TSB decrease body within normal and maintain range. temperature. core >Advise to temperature increase fluid >To provide within normal intake. proper range. ventilation and >Loosen promote release of heat through evaporation.
Assessme Nursing Planning nt Diagnosis Nursing Interventions Rationale Expected Outcome Subjectiv Imbalance Short term: >Review patient’s >To obtain Short term: e: Nutrition: After 4 records. >To reveal change weakness that should be The patient Long Term:>Consult physician made in the shall have > weight client’s dietary demonstrate for of 7. baseline data. furtherassessment appropriate > poor behaviours of specific food. >To promote fluid >Administer management. and lack of nutritional education. d behaviours of nursing nd recommendation or lifestyle > loss of intervention regarding food changes to >For greater appetite s. manifeste nutrition and > Note total daily diet for his d: follow the intake includes disease. muscle or lifestyle tone . IV fluids at prescribed > Antipyretics rate. 2 Imbalanced Nutrition The nutritional requirements of the human body reflect the nutritional intake necessary to maintain optimal body function and to meet the body’s daily energy needs.9kg After 2 days furtherassessment a intake. measures to Objectiv requiremen intervention t related to s. The patient Ө Less than hours of >Assess underlying >To determine shall have the body nursing condition.” and while most people interpret this as undernutrition. the will preferences and understanding and regain demonstrate nutritional support. >Administer antipyretics as ordered. will identify encourage diet for health needs of follow the the measures to age. the promote e: >discuss eating economical patient’s nutrition and habits and >To achieve factors. The etiology of malnutrition includes factors such as poor food availability and preparation. the patient with treatment patient promote the proper food regimen. falling short of daily nutritional requirements. frequently. weight. Long treatment patterns and time of Term: > body regimen eating. Malnutrition (literally. Monitor lower core regulation rate temperature.> high fever > weakness clothing. “bad nutrition”) is defined as “inadequate nutrition. recurrent infections. specific identified interventions.
to individual patients situation.’s trust shall have and promote demonstrated > Determine cooperation. understanding system is After 2 days compromised.O.S. status. Long term: > Evaluate for > To gain The patient’s signs of information S.O. blood as the patient will The patient evidenced by low Hgb count indemonstrate manifested: CBC result behaviour lifestyle >Body changes to temperature improve changes. will factors. shall infection regarding have especially Long term: when immune the verbalized condition.the patient may manifest: > abnormal laborator y studies > pallor changes to regain appropriate weight. behaviour lifestyle factors related > To monitor change. necessary night.O. >Skin discoloratio n The patient may manifest: > Anemia > Establish > To gain Short term: rapport. intervention. Assessmen Nursing t Diagnosis Planning Nursing Rationale Interventions Expected Outcome Subjective: Ineffective tissue Short term: Ө perfusionrealated After 4 hours to decreased Hgb of nursing Objective: concentration in intervention. circulation. 3 Ineffective Tissue Perfusion The circulation to the tissues is not getting enough oxygen or nourishment. verbalize > This understanding > Elevate information of the head of bed at would be condition. for the > Discuss the client’s S. of the of nursing >To observe condition. patient and The patient > Monitor VS. S.O. Decrease in oxygen resulting in the failure to nourish the tissues at the capillary level. > Discuss for possible the patient’s individual risk risk factors. importance of .
the preventfatigue a interventions. 4 Risk for Infection The immune system is the body’s defense against bacteria. therefore it may increase the possibility to increase infection. and other foreign organisms or harmful chemicals. > To increase gravitational blood flow.. it can affect the normal production of WBC from the bone marrow.O. verbalize understanding of >body ways on how to >Monitor weakness prevent spread of and record infection.a healthy diet. Nursing Assessme Diagnosi Planning nt s S=Ø Nursing Intervention Rationale s >To gain their trust and cooperation Expected Outcome Short Term: Risk for Short Term: >Establish (spread) good O = the of After 3 hours of working infection nursing relationship patient manifeste interventions. >To promote Long Term: > Determine optimum level of Long Term: pt’s functioning After 1week of individual After 1week of strength nursing nursing >To interventions. viruses. It is very complex and it has to work properly to protect us from the harmful bacteria and other organisms in the environment which may infect our body. the comparative patient shall have baseline data verbalized understanding of >To know when ways on how to to assist client prevent spread of infection. >To promote a healthy diet to help increase RBC synthesis and Hgb count for faster recovery. vital signs >fatigue >poor muscle tone =The patient may manifest: After 3 hours of nursing >For interventions. the with the client and d: patient will S. If there is an increase in number of WBC. the patient will be >Provide patient shall have nd conserve free peaceful been free energy from infectionsa from infectionsa . If the immune system is compromised.
Hemoglobin is a protein in red blood cells that carries oxygen.97 >HCT = 0.to prevent nd further occurrence of complications.9 >RBC = 3. and work . >To prevent falls and injuries >Emphasize importance >To note for of hand imbalances washing >To ensure >Provide proper hydration safety measures > To replace fluid electrolyte >Monitor I loss &O >Check IV and Regulate IVF >Advice pt to increase oral fluid intake when allowed 5 Risk for Injury A seizure or convulsion is the visible sign of a problem in the electrical system that controls your brain. the SO will > ascertain knwlge . Assessme Nursing Planning nt Diagnosis Nursing Interventions Rationale > To gain patient’s trust >To obtain baseline data Expected Outcome Subjectiv Risk for Short term: >establish rapport e: injury After 4 hours >monitor and Ө related to of nursing record Vital Signs possible interventions Objective convulsion . Therefore. Low levels of hemoglobin in the human body may reult to seizure. such as a high fever and lack of oxygen. A single seizure can have many causes. During episodes of convulsion. patients are prone to injuries since they may strike different objects due to uncontrollable muscle spasms.communit safety.34 >Platelet count = 234 nd further complications environment >.>elevated body temperatu re >Hgb = 112 >WBC = 22. y. modify : of safety needs/ environment injury prevention as indicated the patient to enhance > note clients may Short term: The SO shall have modified environment as indicated > to prevent to enhance injuries in home. furtherinfections >Provide adequate rest and sleep.
behaviors for > discuss importance of self client/SO monitoring of conditions/ >to promote emotions safe physical environment and individual safety >it can contribute to occurence of injury What are febrile convulsions? A febrile convulsion is a seizure in young children caused by a sharp rise in body temperature (fever). Usually. Febrile convulsions otherwise called febrile seizures (fever seizures) or febrile fits (fever fits) can cause a lot of concern among parents because of its sudden onset and frightening nature. & is not related to the duration of the fever or the degree of temperature. It is important to note that episodes such as these occur in relation to a rapid rise in temperature. A convulsion triggered by sudden fever is usually harmless and normally does not indicate a long term or ongoing problem like epilepsy. What are the symptoms of febrile fits? A child experiencing a febrile convulsion may display the following signs and symptoms: • A fever. such as middle ear infections. gender. setting Long term: developmnt stage. the fevers that trigger febrile convulsions are caused by an infection in the infant’s body. but more serious cause of such fevers is an infection of the child’s brain & spinal cord. The risk of fever seizures can also increase after some common childhood immunizations. injury. factors that interventions/safety promote client contribute to devices safety and possibility of model safety injury. or other bacterial or viral infections of the nose & throat. level of ability to protect have cognition/competen self/others and verbalized After 2 days influence choice understandin of nursing ce of interventions/ g of interventions teachings individual . Long term: decision makng >affects client’s The SO shall ability. such as meningitis.manifest the following: >Fever >Convulsi on >Low >Low Hgb Level = 112 safety. the SO will >provide health care within a factors that verbalize contribute to understandin culture of safety >to prevent g of errors resulting possibility of individual > identify in client injury.9 C . What causes of fever seizures? As previously mentioned.. most fever fits occur as a result of a sudden rise in body temperature but it may also develop as the fever is declining. usually higher than 38. age. A less common.
How are fever seizures diagnosed? Febrile fits is diagnosed by the doctor by careful history taking with due consideration given to the age of the baby and the family history In addition. The child may show signs of after effects or damage of the brain. blood investigations and a lumbar puncture is indicated in special situations to rule out any infection. the episode of convulsions lasts for more than 15 minutes. Until the child recovers completely from the fever episode. the child is normal and suffers no after effects although they may act confused and be quite sleepy. but usually disappear by 3-4 years of age. No significant increase in epilepsy unless child has risk factors present. . (PREP article Jan 97: may have a postictal state) Children are neurologically normal with no evidence of focal seizure. The infant should not be restrained & no attempt should be made to stop the seizure movements. Benign Febrile Seizures Definition: A benign condition characterized by a tonic-clonic or tonic seizure occurring in a 6-month-old to 5-year-old that lasts less than 20 minutes and is not accompanied by a postictal state. parents must remember not to panic.• • • • • • Loss of consciousness Jerking of the arms & legs Eyes rolled back in the head Difficulty breathing Vomiting & urinating Crying or moaning Based on the symptoms. applying cool washcloths to the face & back and sponge the rest of the body with cool water. How to prevent fever seizures? Simple benign febrile fits can be prevented from recurring by taking the following precautions : • • As soon as the fever begins. After the episode of fits subside. or if the infant has repeated seizures. benign febrile fits is an episode of convulsions that lasts for less than 10 minutes. A lumbar puncture involves taking a sample of fluid that surrounds the spinal cord to look for any signs infection. Prognosis: Febrile seizures can recur. he has to be watched carefully for any sudden rise in temperature. How are fever seizures treated? When a child starts having fits. If the fit last for longer than five minutes. Measures must be taken to control the fever & reduce the temperature by removing clothing. The nature of convulsions is generalized in that the entire body goes into spasm or becomes stiff. there are two types of febrile convulsions: A simple. the temperature has to be brought down immediately by paracetamol syrup administration and tepid sponging. immediate medical attention is required. Most febrile seizures stop on their own within a couple of minutes. The child must be taken to the doctor when the spell passes. In atypical febrile fits. The child should be placed on his or her side to ensure that the airways remain clear and remove any objects or food from the mouth. The nature of convulsions affects only one part of the body and the seizure occurs more than once in 24 hours.
Workup will need to be complete: EEG. 3. Early Rx with Ibuprofen doesn’t help prevent febrile seizures. b. 6. 6. possible neurology consult. . how long lasted. Depending on nature of seizure and workup. etc. Must inform parents that this is not the same thing as seizures with no risk factors: • • • If one risk factor present: 6-8% later epilepsy If two risk factors present: 17-22% later epilepsy If 3 risk factors present: 49% later epilepsy 2. 5. Reassure parents that there are no problems from recurrent seizures: no brain damage. the color of the child is due to the seizure. Risk factors recurrence: Increased if: a.e. 9% two recurrences. Fever. No need for referral to neurologist. If history and physical are normal fits the category of benign febrile seizure. 3. past medical history. and postictal state. Do not need to order EEG: Don't know what to do with the information once you get it.8% recur with 17% one recurrence. 31. not to cardiac or respiratory arrest. Take careful history of family. and history of actual event – i.more effective than acetaminophen in preventing febrile seizure (Arch Pediatr Adol Med 149:632-637. 5. generalized. Urge parents to give Ibuprofen in future . 2. 4. 3. Positive Family History for Epilepsy Seizure is focal . no increased epilepsy risk. c.1995) 4. 2. anticonvulsant medications may be indicated.not generalized Child is less than 6 months old at time of first seizure Seizure lasts more than 20 minutes Child’s neurological examination is abnormal Repeat seizure occurs with same illness Differential Diagnosis: Seizure with fever: associated with underlying neurological abnormalities How to Approach the Treatment of the Child With Recurrent Febrile Seizures With No Risk Factors: 1. and Risk Factors: 1. first degree relative with febrile seizures. Risk Factors for Later Development of Epilepsy: 1.151:371). 6% 3 or more. low degree of fever when in ER. young age at onset. CT or MRI. How to Approach the Treatment of the Child With Recurrent Seizures. Urge parents: • • DO NOT put things down child s mouth to open the mouth. DO NOT give mouth to mouth resuscitation.Risk of Recurrent Febrile Seizures (Arch Ped Ad Med:97. brief duration between onset of fever and initial seizure.