After a seizure, which safety measure should the nurse implement first to prevent injury?

• A. Pad and elevate the side rails.
• B. Place a padded tongue blade at the bedside.
• C. Restrain the arms.
• D. Attach a seizure precautions sign to the door.

Answer: (A)

The immediate priority during a seizure is to prevent injury by creating a safe environment for the patient. Padding the side rails acts as a protective barrier so movements won’t slam into hard surfaces, reducing the risk of head or body trauma. Elevating the rails further decreases the chance of accidental entrapment or injury against the bed frame. This addresses the most likely mechanism of injury during a seizure—violent, uncoordinated movements near surrounding equipment.

Avoid restraining the arms, which can cause injuries or impair breathing, and do not place a tongue blade at the bedside, as it can cause dental damage or airway obstruction. After the seizure subsides, turn the patient onto the side to help maintain the airway and be prepared to monitor breathing and suction or provide oxygen if needed. Putting a seizure precautions sign on the door doesn’t protect the patient during the event and isn’t the first action to take.