A simple febrile seizure is generalized, lasts under 15 minutes, and does not recur within 24 hours.
Before you read
Test yourself first: 3 questions
Question 1 of 3
An 80-year-old has a body temperature of 99.2 F (37.3 C) and reports feeling unwell. Why should the nurse take this seriously?
Answer: A. Older adults have a lower baseline temperature and a blunted febrile response, so even a low-grade temperature can represent significant infection. The nurse should not dismiss it as normal aging or assume it is always harmless; further assessment is warranted.
Question 2 of 3
A client with a serum sodium of 118 mEq/L is admitted. Which finding is the nurse most concerned about?
Answer: B. Severe hyponatremia causes cerebral edema. New-onset seizures and altered level of consciousness reflect this neurologic emergency and require immediate intervention.
Question 3 of 3
The nurse reviews a serum sodium of 118 mEq/L. Which assessment finding is most concerning?
Answer: A. Sodium of 118 mEq/L is critically low (normal 135-145). Severe hyponatremia causes cerebral edema, so new-onset seizures or altered mental status are the most concerning neurologic findings requiring immediate intervention.
Keep the streak going with more questions like these, each with a full rationale.
What is febrile seizures?
They are usually benign and self-limiting and do not cause brain damage or epilepsy in most children. They are most often associated with a viral illness; the rate of temperature change matters more than the absolute peak.
Key points to remember
- A simple febrile seizure is generalized, lasts under 15 minutes, and does not recur within 24 hours.
- A complex febrile seizure is focal, lasts longer than 15 minutes, or recurs within 24 hours.
- They occur most commonly during the rapid temperature spike, often early in the illness.
- Most children outgrow them by age 5 and have a normal neurologic outcome.
- A family history of febrile seizures increases the likelihood.
- The postictal child may be briefly drowsy or confused after the seizure.
Common causes
- Fast ↑ in fever, viral illness
- Simple < 15 min, generalized
Nursing priorities
- During the seizure, protect the airway: position the child on their side and do not restrain or put anything in the mouth.
- Stay with the child, time the seizure, and clear the area of hazards.
- Administer antipyretics (acetaminophen or ibuprofen) as ordered to reduce fever.
- Treat the underlying cause of the fever and keep the child cool with light clothing.
- Monitor and document seizure duration, characteristics, and postictal state.
Labs & values
Patient teaching
- These seizures are usually harmless and do not mean the child has epilepsy.
- Give antipyretics as directed and dress the child lightly when feverish.
- During a seizure, lay the child on their side, protect them from injury, time it, and never put anything in the mouth.
- Call emergency services if a seizure lasts more than 5 minutes or the child has trouble breathing afterward.
Red flags: report now
- A seizure lasting longer than 5 minutes or repeated seizures (status epilepticus) is a medical emergency.
- Never restrain the child or place objects or fingers in the mouth during a seizure.
- Signs of meningitis (nuchal rigidity, bulging fontanelle, petechial rash, severe lethargy) require immediate evaluation.
- Focal, prolonged, or recurrent seizures need prompt provider notification and workup.
References
Clinical references for this topic
