LPN Nursing · Neurological Disorders in Children · Practice question
A nurse is caring for a school-age child who is experiencing a tonic-clonic seizure. Which of the following actions should the nurse take?
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Prevent movement of the child's extremities.
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Put a tongue blade between the child's teeth.
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Administer magnesium sulfate IM to the child.
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✓
Place a folded blanket under the child's head.
Answer & explanation
Correct: Place a folded blanket under the child's head.
During a tonic-clonic seizure, the priority nursing action is to protect the child from injury. Placing a folded blanket or cushion under the child's head prevents head trauma against a hard surface, which is a safe and effective comfort and injury-prevention measure during the seizure. Preventing movement of the child's extremities is contraindicated because forcibly restraining a seizing child can result in musculoskeletal injury such as fractures or dislocations; the nurse should clear the environment of hazards instead. Placing a tongue blade or any object between the child's teeth is a long-outdated and dangerous practice that can cause oral injury, tooth fractures, or aspiration and should never be done. Magnesium sulfate is used in eclampsia or hypomagnesemia-related seizures in adults; it is not the first-line acute treatment for a tonic-clonic seizure in a child. The correct emergency approach includes positioning the child safely on a flat surface, cushioning the head, turning them to the side after convulsive movements stop to prevent aspiration, and timing the seizure while calling for assistance. These actions reflect current evidence-based seizure first-aid guidelines for pediatric patients.
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