During a generalized seizure, what should the nurse do first?

• A. Maintain the patient's airway.
• B. Reduce external stimuli.
• C. Maintain the patient's privacy.
• D. Perform a brief neurological assessment.

Answer: (A)

Maintaining the airway is the first priority because protecting breathing is the immediate danger during a generalized seizure. Seizures can compromise airway patency and increase the risk of aspiration if secretions or tongue displacement obstruct the airway. The nurse’s first action is to ensure the patient’s airway is open and breathing is supported—loosen restrictive clothing, remove nearby hazards, and, once the convulsions have subsided, place the patient on the side to help drainage and prevent aspiration. Do not put anything in the patient’s mouth or try to restrain movements. After airway safety is addressed, you can focus on other steps such as reducing stimuli, monitoring and assessing neurological status, and providing postictal care.