The nurse is assessing a child with croup in the emergency ...

[ishan]

The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition?
 
  a. Sore throat
  b. Inspiratory stridor
  c. Complete obstruction
  d. Respiratory tract infection

Question 2

A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner?
 
  a. Make her lie down and rest quietly.
  b. Examine her oral pharynx and report to the physician.
  c. Auscultate her lungs and prepare for placement in a mist tent.
  d. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

[kristenb95]

Answer to Question 1

ANS: C
If a child has acute epiglottitis, examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place. Sore throat and pain on swallowing are early signs of epiglottitis. Stridor is aggravated when a child with epiglottitis is supine. Epiglottitis is caused by Haemophilus influenzae in the respiratory tract.

Answer to Question 2

ANS: D
This child is exhibiting signs of respiratory distress and possible epiglottitis. Epiglottitis is always a medical emergency requiring antibiotics and airway support for treatment. Sitting up is the position that facilitates breathing in respiratory disease. The oral pharynx should not be visualized. If the epiglottis is inflamed, there is the potential for complete obstruction if it is irritated further. Although lung auscultation provides useful assessment information, a mist tent would not be beneficial for this child. Immediate medical evaluation and intervention are indicated.

[ishan]

Thank you

[kristenb95]

No problemo