BSN, RN
Seizure disorders are a common neurological disorder in pediatric patients, and nurses are critical in providing immediate support to the child and educating the family.
Seizures can be a single occurrence or a chronic condition, in which cases nurses will discuss long-term management.
Nursing care requires an extensive understanding of seizure types, treatment, and the psychological and developmental needs of the patient.
The Centers for Disease Control and Prevention defines seizures as an event that occurs when there’s an abnormal electrical discharge in the brain. In pediatric patients, the causes of seizures can range from genetic factors, head trauma, or infections to fevers, cerebral palsy, or brain defects.
Seizures are classified into two main categories: generalized and focal seizures. Generalized seizures involve both sides of the brain and affect the whole body, while focal seizures begin in a specific brain area and may only affect one body part, like the face or a single limb.
When your patient has a seizure, your primary role is to keep them safe. Remain calm and protect the patient from injury by moving sharp objects or hazards from the area.
Guide the patient to the floor if they are standing, and do not attempt to restrain the patient, as this could lead to injury. You should also monitor the duration and symptoms of the seizure.
Timing the seizure helps guide care decisions, and it’s vital for tracking seizure activity to know what symptoms the patient was having during the seizure and what characteristics the seizure had. If the patient has any anticonvulsant rescue medications, they are almost always time-based. Specific criteria must be met prior to administering the medication in the event of a seizure.
Ensuring the patient has a patent IV for rescue/emergency medications is essential. Carefully position the patient on their side to reduce aspiration risk. Positioning helps maintain an open airway.
Once the seizure has ended, the patient will enter a postictal phase, which can result in disorientation and fatigue. During this time, you’ll want to reassure and support both your patient and their family, explaining what occurred and addressing any concerns they may have. This not only helps calm the patient but also fosters a sense of understanding and comfort for the family. Don’t forget to monitor and document your patient’s status during the postictal phase as well.
After the seizure, the nursing team should check vital signs and assess the patient for any signs of injury. Provide emotional support to your patient and their family, and maintain a quiet, safe place for recovery. Encourage the family to stay present.
Ensure that you’ve properly documented details of the seizure, such as duration, type, and interventions, to help the care team determine next steps.
Nurses must thoroughly educate the patient and, if applicable, the family, on medication adherence. Everyone should be aware of adverse effects from medication and be given precise directions on administering medications.
Once the seizure triggers are identified, the nurse should educate the family on avoiding and managing them. This includes ensuring the family understands the significance of keeping follow-up appointments. The neurologist will adjust medications and explore alternative therapies while working closely with the family to help keep the patient seizure-free.
Reintegrating a patient into the school environment can present various challenges. Collaboration between the nursing team and school personnel enables the creation of a comprehensive Individualized Education Plan (IEP) tailored to the student.
The IEP will outline seizure protocols that inform school staff about how to respond in case of an episode. It must also include emergency contact information to ensure swift communication if necessary. Furthermore, the IEP should specify any accommodations, additional support during tests or a quiet space to regroup, to enable the patient to thrive academically and socially within the school setting.
Similar to other chronic illnesses, chronic seizure disorders can profoundly impact a child’s self-esteem, emotional health, and quality of life. Nurses need to take an active role in supporting both the patient and their families throughout this journey. This support includes helping families access mental health services and support networks that cater to the unique challenges posed by chronic seizure disorders.
Nurses should emphasize open communication among family members to foster a supportive environment. They can assist families in discussing the child’s experience with seizures, address any fears or misconceptions, and encourage each member to express their feelings.
Reassurance about the nature of the disorder — emphasizing that it’s manageable and many individuals lead fulfilling lives despite it — can also alleviate some of the emotional hardships.
Nurses can equip families with practical strategies to help their patient cope with the challenges associated with their condition. These include teaching them about seizure triggers, discussing safety measures to prevent injury during seizures, and promoting healthy lifestyle choices that can support overall well-being.
By empowering families with knowledge and resources, nurses help enhance the emotional and mental resilience of the child and their families.
Parents and caregivers need to be educated about seizure first aid, the use of emergency medications, and when to seek medical help. You should complete all of this teaching prior to hospital discharge to ensure safety at home, along with information about support groups, advocacy organizations, and online resources.
Nurses are essential to the comprehensive care of pediatric patients with seizure disorders, providing immediate interventions during a seizure and ongoing support for long-term management. With careful monitoring, medication management, thorough family education, and psychosocial support, nurses assist pediatric patients with seizure disorders in living fulfilling, active lives while minimizing the impact of seizures on their daily lives.
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