Seizures in children can be frightening for parents and healthcare providers. For every registered nurse (RN), understanding the difference between febrile seizures and epileptic seizures is essential for safe care and passing the NCLEX exam. In this guide, we’ll break down causes, signs, and nursing priorities for both conditions—keeping it simple and practical for real-life scenarios.
✅ What Are Pediatric Seizures?
A seizure happens when there is abnormal electrical activity in the brain. In pediatric patients, seizures can occur for various reasons, from fever to chronic neurological disorders like epilepsy.
✅ Types of Pediatric Seizures
1. Febrile Seizures
- Definition: Seizures that happen because of a rapid rise in body temperature, often linked to infections like ear infections or viral illnesses.
- Common Age: 6 months to 5 years.
- Key Features:
- Short duration (less than 15 minutes for simple febrile seizures).
- Usually occur during the first day of fever.
- No permanent brain damage.
- Triggers: High fever, family history of febrile seizures.
2. Epileptic Seizures
- Definition: Chronic neurological disorder where the brain has repeated unprovoked seizures.
- Types:
- Generalized seizures: Affect both sides of the brain (e.g., tonic-clonic).
- Focal seizures: Begin in one area and may spread.
- Triggers: Sleep deprivation, stress, flashing lights, missed medication.
✅ Key Differences: Febrile vs. Epileptic Seizures
| Feature | Febrile Seizures | Epileptic Seizures |
|---|---|---|
| Cause | Fever-related | Neurological disorder |
| Age group | Mostly infants/toddlers | Any age |
| Recurrence | Rare (unless fever repeats) | Frequent without treatment |
| Treatment | Usually supportive care | Long-term medication management |
✅ Nursing Priorities During a Seizure
Every nurse must follow these steps during a seizure:
- Ensure Safety First
- Place the child on a flat surface or bed.
- Turn on the side to maintain an open airway and prevent aspiration.
- Do NOT put anything in the mouth.
- Protect the Head
- Use a soft pad or pillow under the head.
- Observe and Document
- Duration of seizure.
- Movements (which limbs? any eye deviation?).
- Level of consciousness before and after.
- Monitor Vital Signs
- Oxygen saturation, heart rate, and respiratory status.
- Administer Medications if Ordered
- For prolonged seizures (>5 minutes), anticipate benzodiazepines (e.g., diazepam, lorazepam).
- Post-Seizure Care
- Allow rest, monitor for postictal confusion, and educate caregivers.
✅ Long-Term Management
- For febrile seizures, focus on fever control and parent education.
- For epileptic seizures, medication compliance is critical. Teach parents about:
- Antiepileptic drugs (side effects, adherence).
- Avoiding triggers (lack of sleep, missed doses).
✅ NCLEX Tips
- Questions often test safety and priority interventions.
- Expect “What’s the FIRST action?” scenarios—correct answer: maintain airway and ensure safety.
- Know which medications stop seizures and which do NOT (antipyretics do NOT stop seizures once started).
✅ Why This Matters for Nursing Students
Understanding seizure management is a must for every nurse, especially in pediatrics. If you’re studying for the NCLEX, this topic often appears under safety and emergency care. For a deeper dive, check our Nursing Bundle, which covers pediatric care, neurology, and critical care in one complete resource for RN nurses.