A nurse is caring for a child who is experiencing a seizure. Which of the following actions should the nurse take? (Select all that apply.)
Loosen restrictive clothing.
Hyperextend the child's neck.
Time the seizure episode.
Place the child in a side-lying position.
Restrain the child.
Correct Answer : A,C,D
Rationale:
A) Loosening restrictive clothing prevents injury during the seizure.
B) Hyperextending the child's neck can cause injury and should be avoided. Instead, the neck should be supported to maintain an open airway.
C) Timing the seizure episode is important for documenting the duration and for providing accurate information to healthcare providers.
D) Placing the child in a side-lying position helps prevent aspiration and maintains an open airway during the seizure.
E) Restraint should not be applied during a seizure unless absolutely necessary to prevent injury to the child or others.
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Related Questions
Correct Answer is C
Explanation
Rationale:
A) Involvement of a grandparent in assisting with activities of daily living (ADLs) indicates family support.
B) The child engaging in play with siblings suggests social interaction and family involvement.
C) A withdrawn parent may indicate emotional distress or difficulty coping with the child's condition, necessitating support and resources.
D) The step-parent's involvement in preparing the child for school transition indicates family support and engagement in the child's development.
Correct Answer is C
Explanation
Rationale:
A) A tepid bath may cause shivering, which can increase the temperature.
B) Aspirin is contraindicated in children due to the risk of Reye's syndrome.
C) Removing the toddler's extra clothing can help lower the body temperature by allowing heat to escape through the skin.
D) Cooling blankets are typically reserved for severe cases of hyperthermia and may not be appropriate or safe for use in a toddler with a moderately elevated temperature.
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