What is the priority initial nursing action during a seizure to maintain airway?

• A. Protect the head, clear the area, DO NOT insert objects into the mouth, loosen restrictive clothing, call for help, and prepare for airway management or suction as needed.
• B. Restrain the patient immediately to prevent injury.
• C. Place a tongue blade between the teeth.
• D. Place a finger between teeth to check bite.

Answer: (A)

When a seizure occurs, the primary goal is to protect the airway and prevent injury while the seizure runs its course. The best initial nursing action is to remove nearby objects that could cause harm, cradle the head to protect it and keep the airway open, loosen tight clothing around the neck, and avoid putting anything in the mouth. After safety measures are in place, call for help and be prepared to assist with airway management or suction if breathing becomes compromised. Placing a tongue blade or fingers in the mouth is dangerous and can cause injury, and restraining the person can lead to harm and does not stop the seizure. If possible, turn the person onto their side after the convulsions stop to help keep the airway clear and reduce the risk of aspiration.