"New" seizure precautions???

Nursing Students NCLEX

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Just took Kaplan - taking the NCLEX 2 weeks from today. They taught us in Kaplan that padding the side rails is NOT appropriate for seizure precautions (contradicting what we were taught in school). They said that the correct method for seizure precautions is to place a mattress on the floor next to the bed (to "catch" the patient if he/she falls out of the bed during a seizure!) The instructor said that padded siderails are not to be used since siderails would be considered a restraint, and you never want to restrain a seizing patient. Any thoughts on this? Should I believe this is actually what they want on the NCLEX?

Specializes in Tele, Stepdown, Med/Surg, education.

They are not referring bed mattresses but rather pads like in a soft gym. We are trying to move away from the negative look of padded side rails. Side rails are only a restraint if all four are used.

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SRDAVIS - that makes a little more sense. I think Kaplan makes it confusing because they simply use the word "mattresses" - so I was picturing 5-inch thick mattresses all over the floor. What Kaplan fails to clarify is what actions must be taken with respect to the already-raised side rails at the moment when the decision is made to implement seizure precautions. It is standard procedure to always keep 2 of the siderails up at all times when a patient NOT on seizure precautions is in bed. I don't hear anyone asking us to stop that practice. So, at the moment when the decision is made to implement seizure precautions, are we supposed to lower all side rails because we're not allowed to pad them and we want to ensure that the patient's ability to fall out of bed is unhindered (onto the 1-inch thick gym mats)? I find it curious that it suddenly becomes okay to leave a patient in bed (with the nurse leaving the room) with no siderails up just because we have 1-inch thick mats on the floor.

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Specializes in Emergency.

Interesting. At my hospital, we pad side rails & have them all up. When all 4 side rails are up per seizure precautions, they are not considered to be a restraint.

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the NCLEX is theory-based.... not real-world experience. "ivory tower nursing"

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Specializes in PCU, M-S, ER, OPD, Dental nurse, etc..

It's true that in US putting up patients siderails without physician's order is a no no and also considered restraint to a patient. Anyway a friend of mine had a situation like this but not a patient with seizure unfortunately the patient fell from her bed and she was ask of course to do an incident report about putting up siderails without written order and the patient's fall. So back to your question, I think it's just right to put that mattress down the floor just in case of fall. We may not prevent the fall but we can prevent further injury of the patient, right? Good luck. So we need to be familiarize with their system.:nurse:

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I just saw this post while searching for seizure precautions. The NCLEX is designed for "ideal" nursing management (ie, ADPIE, etc). You do have to think differently on the floor. Padding the side rails may not be "ideal" by NCLEX standards, but when you have a patient seizing and the client's head gets trapped in the siderails, or gashes the head against the plastic from seizing, that is why the padding is in place, not for seizures, but prevention of patient harm.

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