2. Febrile seizures
   • Introduction: Febrile seizures are transient neurological disorders of childhood, affecting perhaps as many as 3% of all children. Although the exact cause of febrile seizures remains uncertain, they seem to be a relatively transient problem that occurs exclusively in the presence of high, spiked fevers. Children in the infant and toddler stages (6 months-3 years) appear to be most susceptible to febrile seizures, and they are twice as common in boys as in girls. There also appears to be an increased susceptibility within families, suggesting a possible genetic predisposition. Note: Epilepsy is discussed in Unit 7.
   • Assessment:
     1. History usually reveals presence of URI or gastroenteritis.
     2. Occurs with a sudden rise in fever: often spiked and quite high (102°F or higher) vs. prolonged temperature elevation.
   • Analysis/nursing diagnosis:
     1. Risk for injury related to seizures.
     2. Knowledge deficit related to prevention of future seizures, care of child having a seizure and possible long-term effects.
   • Nursing care plan/implementation:
     1. Goal: reduce fever/prevent further increase in fever.
        • Administer antipyretics, as ordered: acetaminophen only (not aspirin).
        • Use cool, loose, cotton clothes to decrease heat retention.
        • Sponge with tepid water 20-30 min; avoid shivering, which increases metabolic rate and temperature.
        • Encourage child to drink cool fluids.
        • Monitor temperature hourly.
        • Minimize stimulation, frustration for child.
     2. Goal: teach parents about care of child who experiences febrile seizure.
        • Discuss how to prevent seizures from recurring: best method is to prevent temperature from rising over 102°F .
        • Discuss how to handle seizures if they do recur: prevent injury, maintain airway, etc.
        • Answer questions simply and honestly:
          1. 25% of children with one febrile seizure will experience a recurrence.
          2. 75% of recurrences occur within 1 year.
          3. Reassure parents of the benign nature of febrile seizures; 95-98% of children with febrile seizures do not develop epilepsy or neurological damage.
   • Evaluation/outcome criteria:
     1. Fever is kept below 102°F; additional seizures are prevented.
     2. Parents verbalize their understanding of how to care for child at home.