Febrile Seizure.pptx(Patty )

8/8/2019 Febrile Seizure.pptx(Patty )

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FEBRILE SEIZURE


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Definition:Febrile seizure is associated

with high fever

(38.9 C 40.0 C). Seizures showan active tonic-clonic

pattern, which lasts for 15-20seconds.

It usually occur due to thesudden spike of

temperature.It happen most often when a

child develops a fever atnight, when a parent is not

aware of it.


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Febrile seizure are divided into 2 types:

Simple febrile seizures which are generalized,

last


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Pathophysiology:

Febrile seizures occur in young children at atime in their development when the seizure

threshold is low. This is a time when a youngchildren are susceptible to frequent

childhood infections such as upper

respiratory inf ection, otitis media, viral

syndrome, and they respond with

comparably higher temperature. Animalstudies suggest a possible role of endogenous

pyrogens such as interleukin 1beta, that by

increasing neuronal excitability, may link

fever and seizure activity.


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Diagnostic evaluation:

Physical examination with special attention

to neurologic status.

Cerebrospinal fluid examination Complete blood count and urinalysis

Cultures of nasopharynx , blood, or urine as

appropriate to determine cause of fever. Blood sugar, calcium and electrolyte levels.

EEG


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EEG, with or without video monitoring,

locates epileptic focus, spread, intensity,and duration, helps classify seizure type.

CT scanning or MRI identifies lesion that

may cause of seizure.

Single photon emission CT scanning(SPECT) or positron emission tomography

(PET) identifies seizure foci.


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Therapeutic Management:

Teach parents that, afterthe seizure subsides,they should sponge thechild with tepid water to

reduce the fever quickly.

Advice them not to putthe child in the bathtub,however, because itwould be easy for thechild to slip underwatershould a second seizure

occur.


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Applying alcohol or cold water is not

advisable.

Parents should not attempt to give oral

medications such as acetaminophen, because

the child will be in a drowsy, stare after theseizure and might aspirate the medicine.


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Advise parents to put a cool washcloth on the

childs forehead, axillary, and groin areas andtransport the child, lightly clothed, to a healthcare facility for immediate education.


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Do not try to restrain your child or try to stop

the seizure movements.

Focus your attention on bringing the fever

down.


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Teach the parents to loose any tight clothing,

especially around the neck. If possible, open

or remove clothes from the waist up.

Do not force anything into the babys mouth

to prevent him from biting the tongue, as thisincreases the risk of injury.


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Nursing Management:

Increase the childs fluidintake to prevent

dehydration.

Rationale:

Fever increases the childsfluid requirements by

increasing the

metabolic rate.


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Expose the skin to the air

by leaving the childlightly dressed in anabsorbent material.

Rationale:

Loss of heat from the skin

by radiation in the maintemperature regulatingmechanism available to

the infant or small child.


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Administer a tepid

sponge bath.

Rationale:The temperature is

lowered by evaporation

of water from the

surface of the skin.


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Administer antipyretic drugs.

Rationale:

Although effective in reducing fever,antipyretic drugs may obscure the clinical

picture and cause numerous side effects

including diaphoresis, skin eruptions,nausea, vomiting, hematologic changes

and fever.


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Use tub or a hypothermia blanket.

Rationale:

A tub bath is less frightening and is the preferredmethod for reducing fever if the child is able tocooperate.


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Medication:

Antipyretic drugs should be used in patientswho appear uncomfortable secondary to the

fever. Antipyretics do not appear to preventrecurrence of febrile seizures.

Acetaminophen (tylenol)

Reduces fever by acting directly on hypothalamic

heat-regulating centers, which increasesdissipation of body heat via vasodilation andsweating.


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Some children who have repeated episodes of

multiple febrile seizures are treated with

Phenobarbital or Dekote (Valproate) Other medications can be given at the time of a

febrile seizure. Diastat (diazepam) gel or liquid

diazepam can be given by rectum.

Klonopin (clonazepam) wafers can be placed on

the tongue or a tablet form of diazepam orlorazepam can be crushed and put between the

cheek of the gum.

Febrile Seizure.pptx(Patty )

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