. 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 D
Explanation
A. Pneumococcal conjugate vaccine (PCV): This vaccine is generally completed before the age of 5, so it is not typically administered at this stage.
B. Hepatitis B (HBV): The HBV series is usually completed during infancy and early childhood, so it is not needed at 5 years if the child is up to date.
C. Haemophilus influenzae type B (Hib): Hib is typically completed by 18 months of age and is not required for pre-kindergarten.
D. Measles, mumps, and rubella (MMR): A second dose of MMR is typically required at 4-6 years, aligning with pre-kindergarten vaccination schedules.
Correct Answer is B
Explanation
A. Apply oxygen by nasal cannula: Applying oxygen can be beneficial but is not the immediate priority during an active seizure. Protecting the airway comes first.
B. Turn the client to a lateral position: This action prevents aspiration by keeping the airway clear if the client vomits or has excessive secretions.
C. Administer an anticonvulsant medication: Medications may be necessary later, but immediate safety and airway protection take precedence.
D. Check the client’s oxygen saturation: Monitoring oxygen saturation is important but should follow positioning to ensure airway protection.