INTRODUCTION The immune system is responsible for knowing the difference between normal bodily substances and foreign

ones, as well as protecting the body from infections and foreign substances. Different immune response can be perceived if an opportunistic microorganism is introduced in the body. One common response of the body seen in children from infection is fever. It is a physiologic response of the body that accompanies childhood illnesses, especially infections. Febrile seizures are convulsions brought on by a fever in infants or small children. During afebrile seizure, a child often loses consciousness and shakes, moving limbs on both sides of the body. Less commonly, the child becomes rigid or has twitches in only a portion of the body, such as an arm or leg, or on the right or the left side only. Most febrile seizures last a minute, although some can be as brief as a few seconds while others last for more than 15 minutes. The latter is called complex febrile seizure. Febrile seizures usually occur in children between the ages of five months and five years and are particularly common in toddlers. Children rarely develop their first febrile seizure before the age of six months or after three years of age. The older a child is when the first febrile seizure occurs, the less likely that child is to have more. Several factors can contribute to febrile convulsion. Before 5 years of age, the child has not yet fully developed his/her hypothalamic control center therefore temperature can easily fluctuate. Family history of this particular seizure can also contribute in developing benign febrile convulsion. Infection can be another causative factor in the occurrence of febrile seizure

NURSING HISTORY A. Demographic Data

Pierce John is a 7 year old Filipino boy from Barangay Babasit, Manaoag who is currently studying in Manaoag Elementary School. He was born February 22, 2005 to Mrs. Gina Alipaspas full term through a normal spontaneous delivery with birth weight of 5 kg. Both his parents are working at Manila as told by the patients guardian. B. Initial Data

Pierce John was admitted on the 19th day of September year 2012 at the time of 9:15 in the morning in the Pediatric ward Hospital #18124. He was admitted with a diagnosis of Benign Febrile Convulsion without CNS infection.

C. Chief complaint of Fever. D. History of Present Illness Few hours prior to admission of high grade fever associated with convulsion prompt to consult hence the admission. Patient had episodes of cough and colds.2 days PTA, patient does not have colds anymore but he still has cough.

OBJECTIVES

General Objective

This aims to distinguish and verify the general health problems and needs of the patient with an admitting diagnosis of Benign Febrile Seizure without CNS infection. This will help enhance the knowledge and skills of the researcher and relate to Pediatric Nursing concepts to her actual related learning experience as a student nurse. This will help the patient know importance of health and its medical understanding of the said condition through the application of nursing skills.

Specific Objective

To perform physical assessment in a head-to-toe approach. To have a review of the anatomy and physiology of the systems affected. To trace the pathophysiology of febrile seizure. To determine and understand the different medical and nursing management employed. To interpret the results of the laboratory and diagnostic procedures. To study the drugs prescribed to the patient and its effects to her current condition. To formulate and apply nursing care plan utilizing the nursing process. To learn new clinical skills required in the management of the patient who had suffered febrile seizure. To render nursing care and information through the application of the nursing skill Developmental Task Psychosocial- (Erik Erikson): Industry vs. Inferiority The sense of industry to be achieved which is described as to how can he be good and what kind of person he will be. They will be adjusting to a new body image. They strive to master new skills; develop a feeling of competence and belief in their skills. During school and other social activities, he receives praise and attention for performing various tasks such as reading, writing, drawing and solving problems. Cognitive- (Jean Piaget) Pre-operational thought (Intuitive thought Phase) Children tend to become very curious and ask many questions; begin the use of primitive reasoning. There is an emergence in the interest of reasoning and wanting to know why things are the way they are. In Piaget's most famous task, a child is presented with two identical beakers containing the same amount of liquid. The child usually notes that the beakers have the same amount of liquid.When one of the beakers is poured into a taller and thinner container, children who are younger than 7

or 8 years old typically say that the two beakers no longer contain the same amount of liquid, and the taller container holds the larger quantity. The child simply focuses on the height and width of the container compared to the general concept Moral- Kohlberg (Pre- convention, Level 2) In my observation my patient is at this level because he knows how to find ways to make him satisfy his wants. For example: During my shift of handling him, he is boring then he find ways to entertain himself by playing on the phone and by listening to music.

REVIEW OF ANATOMY AND PHYSIOLOGY

Temperature control in children is not completed until approximately five years of age. This may be due to the immaturity of the nervous system. The maintenance of body temperature is mainly coordinated by the hypothalamus, a central control center containing large numbers of heathsensitive neurons called thermo receptors. It is an important homeostatic mechanism which allows the body enzymes to work efficiently within a narrow range of 36.5-37.5 C. In response to a change in temperature, the peripheral thermo receptors transmit signals to the hypothalamus, where they are integrated with the receptor signals from the pre optic area of the brain. The normal set point in childhood reflects a decreasing basic metabolic rate (BMR) as the child

grows. The body temperature of the three-month-old child is 37.5 C, whereas at thirteen years it is 36.6C. Even as the temperature regulatory mechanisms mature through childhood, babies and small children are highly susceptible to temperature fluctuations, as they produce more heat per kilogram of body weight than older children. Changes in environmental temperature, increased activity, crying, emotional upset and infections all cause a higher and more rapid increase in the younger child. The younger the child the less able he or she is to vocalize the feeling of hot or cold or to do something about it. All children may also become too cold. Small individuals who do not have warm clothes and warm homes will not grow if the temperature of their environment is consistently low. They will use much of the energy from their food intake to generate heat (metabolic rate) and leave no spare calories for tissue growth. The smaller the child, the larger the surface area for heat loss in relation to body mass. The head of a small child is relatively larger in proportion to the rest of the body, and covering the head in a cold environment conserves heat for growth. Schoolchildren may experience a sequence of small growth spurts and at times be relatively thin with minimal body fat. At the swimming pool, for example, where children enjoy jumping in and out of the water as they play, thin children may become cold more quickly than their fatter friends who have an insulation layer beneath their skin. Heat can generated through the metabolism of the liver, muscles, and other chemical activities. When children are exposed in a cold environment, it can result to hypoglycemia, elevated serum bilirubin, metabolic acidosis, and increased metabolic rate. When heat loss occurred, non-shivering thermogenesis (NST) heat production takes place in the subcutaneous tissue, hypothalamus, and spinal cord to compensate for the sudden change in temperature. Heat loss transpires through the contact in a cold environment, vasodilation, sweating where the pre optic area of the brain stimulates secretion of water to the skin for evaporation. There are different areas in the body where we can measure the temperature such as axillae, tympanic membrane, and mouth

PATHOPHYSIOLOGY

Non-modifiable Factors: -Under developed hypothalamic control centre. - Infection

Modifiable Factors:

-Hygiene -Diet Environment

LABORATORY AND DIAGNOSTIC PROCEDURES Hematology Report: Laboratory Findings: September 18, 2012

NORMAL VALUES

ACTUAL RESULT

WBC Count

4.80-10.80% 60-70%

10.4%

Lymphocytes Eosinophil

30-40% 1-3% 130-400

0.13% 1

Interpretation: There is a decrease in hemoglobin and an elevated white blood cell count. Other blood components are within the normal level. Analysis: A decrease in hemoglobin is physiologically low normal because of the increasing demands of the body for iron. An evident increased in white blood cell count indicates that a bacterial infection ispresent

http://www.medicinenet.com/complete_blood_count/glossary.htm