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BENIGN FEBRILE COVULSION Introduction A febrile seizure is a convulsion in a child triggered by a fever.

Such convulsions occur without any underlying brain or spinal cord infection or other neurological cause. 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 lifes 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. However, a very small percentage of children go on to develop other seizure disorders such as epilepsy later in life. 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 bodys defense against infection. Antigens or microorganisms cause inflammation and the release of pyrogens which is a substance that induces fever. Pathophysiology: RF: Age(6 months-3 years old), Family history, Infection or inflammation pyrogens (probably cytokines and prostaglandins) hypothalamic set point is raised and neurons in the vasomotor center are activated heat conservation/ production

changes in human behavior Symptoms o o o o o o Convulsions Tonicclonic seizure Fevers High fever Muscle contraction High temperature Complication o o o o Ectodermal dysplasia Exanthema subitum Hand - foot - mouth disease Pneumonia

shivering

Treatment:

1. Reassure parents that there are no problems from recurrent seizures: no brain damage, no increased epilepsy risk, etc. 2. Take careful history of family, past medical history, and history of actual event i.e. generalized, how long lasted, and postictal state. If history and physical are normal fits the category of benign febrile seizure. 3. Urge parents to give Ibuprofen in future more effective than acetaminophen in preventing febrile seizure (Arch Pediatr Adol Med 149:632-637;1995) 4. Urge parents: * DO NOT put things down child s mouth to open the mouth. * DO NOT give mouth to mouth resuscitation; the color of the child is due to the seizure, not to cardiac or respiratory arrest. 5. Do not need to order EEG: Dont know what to do with the information once you get it. 6. No need for referral to neurologist.

NCP Assessment Subjective: Objective: the patient manifested: > febrile temp = 39C >flushed skin and warm to touch > convulsion Nursing Planning Diagnosis Hyperthermia Short term: Nursing Interventions >Assess underlying condition and body temperature. Rationale >To obtain baseline date. Expected Outcome Short term:

After 4 hours of nursing interventions, the >Monitor and patients recorded vital signs. temperature will decrease from 39C >Remove to normal range of unnecessary clothing 36.5C to 37C. that could only aggravate heat. Long Term: >Promote adequate After 2 days of rest periods. nursing interventions, the >Provide TSB patient will be able to be free of >Advise to increase complications and

The patients >To note for temperature shall progress and have decreased evaluate effects from 39C to of hyperthermia. normal range of 36.5C to 37C. >To decrease or totally diminish Long Term: pain. The patient shall >Reduces have been able to metabolic be free of demands or complications oxygen. and maintain core temperature within normal range.

> RR = 34 bpm the patient may manifest: > high fever > weakness

maintain core fluid intake. temperature within normal range. >Loosen clothing.

>To promote surface cooling.

>To help >Administer IV fluids decrease body temperature. at prescribed rate. Monitor regulation rate frequently. >To provide proper ventilation and >Administer promote release antipyretics as of heat through ordered. evaporation. >To promote fluid management. > Antipyretics lower core temperature.

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