Nursing Care Plan for Pediatric Febrile Seizures

Nursing Care Plan for Pediatric Febrile Seizures

Definition of Febrile Seizures

Febrile seizures are seizures that occur on the rise in body temperature (rectal temperature of more than 380C) which is caused by an extra-cranial process. Febrile seizures occur in 2-4% of children aged 6 months - 5 years. Children who have had seizures without fever, then re febrile seizures are not included in the febrile seizures. Febrile seizures in infants younger than 1 month are not included in the febrile seizures. When children aged less than 6 months or more than 5 years experience seizures preceded by fever, think of other possibilities, such as central nervous system infections, or epilepsy that happen to occur along a fever.


Etiology

Until now, the etiology of febrile seizures is not known with certainty. Fever is often caused by:

• upper respiratory tract infection,
• otitis media,
• pneumonia,
• gastroenteritis, and
• urinary tract infection.

Seizures are not always arise at high temperatures. Sometimes that is not so high can cause seizures.
Other causes of febrile seizures is the use of certain drugs such as diphenhydramine, tricyclic antidepressants, amphetamines, cocaine, and dehydration resulting in disruption of water-electrolyte balance.


Risk Factors

While the factors that affect febrile seizures are:
1. Age

• 3% of children under 5 years old have experienced febrile seizures.
• The highest incidence occurred in the age of 2 years and decreased after 4 years, rarely occurs in children under the age of 6 months or more than 5 years.
• The first attack usually occurs within the first 2 years and then declines with age.

2. Gender

• Febrile seizures are more common in boys than girls by a ratio of 2: 1. This may be caused by cerebral maturation faster in women than in men.

3. Body temperature

• The increase in body temperature is an absolute requirement of febrile seizures. High body temperature at the time of the attack raised seizure threshold value. Seizure threshold is different for each child, ranging between 38.3 ° C - 41.4 ° C. The big difference in this seizure threshold, explain why in a new child seizures arising after body temperature rises very high, while the other child has seizures arise even if the temperature increase is not too high. From this fact it can be concluded that the recurrence of febrile seizures will be more frequent in children with a low seizure threshold.

4. Heredity

• Heredity plays an important role for the occurrence of febrile seizures. Some authors found that 25-50% of children who have febrile seizures have family members (parents, siblings) who have experienced febrile seizures at least once.

Risk factor for febrile seizures first important thing is fever. Febrile seizures tend to arise within the first 24 hours at the time of illness with fever or during high fever.

Other Factors include:

• a history of febrile seizures in parents or siblings,
• delayed development,
• problems in the newborn period,
• children in special care, and
• low sodium levels.

After the first febrile seizure, approximately 33% of children will experience one or more recurrences, and approximately 9% of children experienced recurrence or 3 times more. The risk of recurrence increases with an early age, children quickly get after febrile seizures arise, low temperatures when convulsions, a family history of febrile seizures, and family history of epilepsy.

About 1/3 of children with first febrile seizure may experience recurrent seizures.
Risk factors for recurrent febrile seizures include the following:

• Young age when the first febrile seizure.
• Low temperature when the first seizure.
• Family history of febrile seizures.
• The duration between onset of rapid onset of fever and convulsions.

Patients with these risk factors have more than 70% chance of recurrence. Patients without these risk factors have less than 20% chance of recurrence.


Assessment - Nursing Care Plan for Febrile Seizures