A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

Choice A rationale Inserting any object into the mouth of a person having a seizure is extremely dangerous and contraindicated. It can lead to broken teeth, oral trauma, or the object being bitten off and aspirated, causing an airway obstruction. There is also a significant risk of injury to the rescuer's fingers. Modern first aid protocols emphasize that nothing should ever be placed between the teeth, as the tongue cannot actually be swallowed during a seizure event. Choice B rationale The prone position, where the child lies on their stomach, is unsafe during a seizure because it can obstruct the airway and prevent adequate chest expansion. If the child is on the floor, they should be placed on their side in a lateral rescue position once it is safe to do so. This lateral positioning helps prevent aspiration of saliva or vomitus and ensures that the tongue does not fall back to occlude the posterior pharynx. Choice C rationale Attempting to physically restrain a child during tonic-clonic movements can lead to musculoskeletal injuries, such as fractures or muscle strains. The force of the involuntary muscle contractions is significant, and fighting against them does not stop the seizure. The nurse should instead focus on protecting the child from the environment. Restraint can also increase the child's agitation and confusion during the postictal phase, making the recovery period more difficult for the patient. Choice D rationale During a seizure, rhythmic muscle contractions can cause clothing around the neck or chest to become tight, potentially interfering with breathing or venous return. Loosening ties, collars, or restrictive waistbands helps ensure that the airway remains as clear as possible and that the child’s respiratory efforts are not hindered by external pressure. This is a standard safety intervention that focuses on maintaining physiological stability without causing further injury or attempting to stop the involuntary movements. Choice E rationale The primary goal during an active seizure is to prevent secondary injury from the environment. Moving furniture, sharp objects, or hard equipment away from the child reduces the risk of lacerations, contusions, or head trauma. If the child is on a hard surface, a soft item like a folded jacket may be placed under the head. Creating a clear, safe perimeter allows the seizure to run its course while minimizing the chance of the child striking a dangerous object.