. An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse call 911?
The child is confused and cannot remember anything regarding the seizure.
The child fell at the onset of the seizure
The seizure lasts more than 5 minutes.
The child is sleepy and lethargic after the seizure
The Correct Answer is C
A. The child is confused and cannot remember anything regarding the seizure: Postictal confusion is normal after a seizure and does not require emergency services.
B. The child fell at the onset of the seizure: Falls can occur with seizures, but unless there is a suspected injury or prolonged seizure activity, calling 911 is unnecessary.
C. The seizure lasts more than 5 minutes: A seizure lasting more than 5 minutes is considered status epilepticus and is a medical emergency requiring immediate intervention.
D. The child is sleepy and lethargic after the seizure: Postictal sleepiness is a common and expected phase after a generalized seizure.
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Correct Answer is C
Explanation
A. Insomnia: Infants with increased ICP are more likely to be lethargic than to have insomnia.
B. Positive Babinski reflex: A positive Babinski reflex is normal in infants under 2 years and does not indicate ICP.
C. Bulging fontanel: A bulging fontanel is a classic sign of increased ICP due to the accumulation of fluid or swelling inside the skull.
D. Low-pitched cry: Infants with ICP typically have a high-pitched cry, not a low-pitched one.
Correct Answer is ["A","D"]
Explanation
A. Clear the area of hard objects: This prevents injury to the child during the seizure.
B. Place a tongue depressor in the child's mouth: This is contraindicated as it can cause injury to the oral cavity or obstruct the airway.
C. Place the child in prone position: This position is unsafe during a seizure and could compromise the airway. The lateral position is recommended to reduce aspiration risk.
D. Loosen restrictive clothing: Loosening clothing promotes easier breathing and comfort during the seizure.