NCMA COURSE TASK # 13

Jack, age 6 years, was admitted to the pediatric unit for diagnosis and treatment of a possible
seizure.

1. What are the two major foci of the process of diagnosis in a child with a seizure
disorder? (5pts)
❖ The 2 major Foci is determining whether epilepsy or seizure exist and not an
alternative diagnosis and defining the underlying cause, if possible. The
assessment and diagnosis rely heavily on a thorough history, skilled observation,
and several diagnostic tests. It is especially important to differentiate epilepsy
from other brief alterations in consciousness or behavior. Clinical entities that
mimic seizures include migraine headaches, toxic effects of drugs, syncope
(fainting), breath-holding spells in infants and young children, movement disorder
(tics, tremor, chorea), prolonged QT syndrome, sleep disturbances (night terrors),
psychogenic seizures, rage attacks, and transient ischemic attacks (rare in
children). A detailed clinical history is crucial to accurate diagnosis and should be
obtained from the child (when possible) as well as directly from the person who
witnessed the event. Children as young as 3 years of age can provide very useful
information regarding both aura and postictal phase. In addition to obtaining a
careful verbal description of seizures, it is often helpful for the witnesses to
“mime” the event.

2. While the nurse is assisting with breakfast, Jack has a brief loss of consciousness. The
nurse noted that his eyelids twitched and his hands moved slightly. He then needed to
reorient himself to previous activity. How would the nurse keep Jack safe? (15pts)
● Obtaining a careful verbal description of seizures, it is often helpful for the
witnesses to “mime” the event. The nurse must help Jack doing the previous
activity and should obtain a complete description of the event from the beginning
to end, including the details of the seizure itself. The nurse must help/support
Jack until he is back to his consciousness.