A father calls emergency medical services (EMS) for his 1-year-old infant who was vomiting and then experienced a series of seizures. Upon admission to the hospital, the infant was listless and irritable, had bradycardia, and had periods of apnea

Question

The infant has now lapsed into a coma. Which of the following conditions will the nurse and the health care team members suspect and most want to rule out? a. spinal meningitis c. fever-induced seizures
b. encephalitis d. shaken baby syndrome (SBS)

Answer 1

D

Feedback
A Incorrect: These manifestations are similar to those seen in spinal meningitis, but the health care team members would be most concerned and want to rule out SBS. The infant is at risk for additional injuries (death) from shaking if abuse has occurred. One-third of children with SBS die from their injuries; and one-third experience permanent injury.
B Incorrect: Some of these manifestations also occur in encephalitis. However, health care team members would be most concerned and want to rule out SBS. The infant is at risk for additional injuries (death) from shaking if abuse has occurred.
C Incorrect: Fever-induced seizures are brief, clonic, or tonic, clonic in nature. The other manifestations in this situation would not be evident with fever-induced seizures.
D Correct: Infants should be suspected of SBS with any signs of head injury, including poor feeding or vomiting, irritability, listlessness, lethargy, bradycardia, apnea, seizures coma, bulging fontanels, large head circumference, hypothermia, or failure to thrive. The classic triad of SBS is hematoma, brain edema and retinal hemorrhages, usually bilateral.