FEBRILE CONVULSIONS Flashcards
(18 cards)
Mrs Kalu brought her son to the clinic with complaints of fever, while waiting for review, his mum noticed jerking movements of his body, take a focus history
Grip
Bio data
BIODATA (NASORATI)
Name: What is this child’s name
Ade. How old Is he
Sex: please confirm that this is a male child
Occupation: what class is he In
Religion: what religion do the parents practice
Address: where to the parents live
Tribe: what tribe are the parents informant.What is your relationsnip to this child
Presenting complain :
5 C’S
I see you are complaining of fever and seizure/jerky movements in your child? Is that right? Which one started first ?
Fever
How long did it start
Did it start suddenly or gradually
Since it started has it gotten worse, better or remain same
Did you check the temperature
What was the value, low or high?
Is the fever worse at any particular time
Any chills or headaches
Any vomiting, reduce appetite
Seizure
When did it start
How many episodes so far
How long did it last
How long between each episode
PREICTAL
Did he complain of any strange smell, taste, epigastric or abdominal pain or flashing of light before the seizure
ICTAL
Did the seizure involve all his body or just one part
Did he bit his tongue during the seizure
What was used to stop the seizure? Any cow urine, palm oil?
Or did you place any obiect in his mouth
Post ictal
was there any loss of consciousness after seizure
Did he urinate or defecate in himself
Did he sleep immediately after the seizure
Causes
1)Family history: Has there been any history of similar symptoms in the family
2) Malaria: do you use mosquito nets at home or do you live close to stagnant water
3) Upper respiratory tract infections: has the child been coughing or having catarrh recently
4) Otitis media: has he been tugging at his ear, has there been an ear discharge
) Urinarv tract infection : has there been an history of vaginal or penile discharge . any history of painful urination?
tetanus : did he have any recent cut from any sharp oblect
or rusted object
7) Meningitis : any history of neck pain, neck stiffnes, irritability
8) Gastroenteritis: any history of abdominal pain, vomiting.
passage of loose stool
9) Osteomyelitis: any history of bone pain, bone swelling
10) hypoglycemia: when was his last meal before the seizure
Complications
Trauma:
Did he fall during the seizure, did he sustain any injuries
Cerebrovascular injuries:
Has there been any change in his vision or behavior since the seizure
Hydrocephalus
Any increase in the head shape
Increase Intracranial Pressure:
Any headache and recurrent vomiting
Care so far
What have you done so far
Any visit to prayer house, pharmacy or hospital
Any investigation
Have you taken any medication
Past medical history
Any similar symptom in the past
Any chronic disease eg HEADS
Any history of surgery, blood transfusions, or hospitalization in the past ?
Immunization history
Is he up to date with his immunization
Do you have your immunization card
Did he have any reaction to his vaccines
Developmental history
Did he cry immediatelv after birth
Was he admitted immediatelv after birth
How long did he stay in the hospital
When did he start smiling
When was he able to sit / stand without support
When did he start walking
older children
what class is he in
How is his performance at school
How is his relationship with his school mates
Family history
Is there any one with similar symptoms in the family
Any history of hypertension, epilepsy, asthma, diabetes or sickle cell disease
How many children do you have
Are you in a monogamous or polygamous marriage
How many boys and girls
What is this child’s position in the family
Social history
Who prepares his meals
What is your source or water supply and sewage disposal
What kind of toilet do you use
What kind of house do you live in, how many rooms, how many
Nutritional history
Did you give your baby breast milk only for the first 6 month
“ how often do you breast feed” - infant
When did you introduce other meals
Frequency - how many times does he eat in a day
Adequacy - does he finish his food and ask for more
density - does his meal contain all the classes of food in the
right proportion
Utility - do you think your child is growing well
Pregnancy history
Was this preanancy booked for antenatal
DId you have any infection during your pregnancy
Did you get your vaccines
Was the delivery at term
What was the mode of delivery? Was it vaginal or caesarean
section
was there any use of instruments during vour vaginal delivery
Did he cry immedlately after birth
Was he admitted immediately after birth
How long did he stay in the hospital
Past medical history
Any history of chronic diseases like epilepsy, asthma, diabetes Or sickle cell disease
Any history of surgery, hospitalization or blood transtusion in The past ?
Review of system
