The practical nurse (PN) is caring for a child who was admitted after experiencing a generalized tonic-clonic seizure. When witnessing the child begin to seize again, which actions should the PN implement immediately? (Select all that apply.)

A. Observe the progression of the seizure: Monitoring the duration, type of movements, and body areas involved provides essential information for evaluating the seizure and planning treatment. Accurate observation helps guide postictal assessment and physician reporting. B. Hold the extremities close to the body: Restricting movement during a seizure can cause musculoskeletal injury or increase agitation. The PN should instead ensure the child’s safety by allowing free movement within a protected area. C. Pad the side rails with pillows: Padding the side rails prevents injury from hitting hard surfaces during convulsions. It is a standard safety measure when caring for clients at risk for seizures. D. Insert a tongue blade between the teeth: Forcing any object into the mouth during a seizure can cause oral trauma, broken teeth, or airway obstruction. Nothing should be inserted into the child’s mouth while seizing. E. Loosen clothing around the neck: Loosening tight clothing helps maintain airway patency and reduces the risk of restricted breathing during seizure activity.