A 3-year-old child woke up in the middle of the night with a ...

[jace]

A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved.
 
  What can the nurse teach the parents with regard to this type of croup?
  a. A bath in tepid water can help resolve this type of croup.
  b. Tylenol can help to relieve the cough and stridor.
  c. A cool mist vaporizer at the bedside can help prevent this type of croup.
  d. Antibiotics need to be given to reduce the inflammation.

Question 2

A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action?
 
  a. Throat culture
  b. Nasal pharynx washing
  c. Administration of corticosteroids
  d. Emergency intubation

[kaylee05]

Answer to Question 1

ANS: C
Acute spasmodic laryngitis (spasmodic croup, midnight croup, or twilight croup) is distinct from laryngitis and LTB and characterized by paroxysmal attacks of laryngeal obstruction that occur chiefly at night. The child goes to bed well or with some mild respiratory symptoms but awakens suddenly with characteristic barking; a metallic cough; hoarseness; noisy inspirations; and restlessness. However, there is no fever, and the episode subsides in a few hours. Children with spasmodic croup are managed at home. Cool mist is recommended for the child's room. A tepid water bath will not help, but steam provided by hot water may relieve the laryngeal spasm. The child will not need Tylenol, and antibiotics are not given for this type of croup.

Answer to Question 2

ANS: D
Three clinical observations that are predictive of epiglottitis are absence of spontaneous cough, presence of drooling, and agitation. Nasotracheal intubation or tracheostomy is usually considered for a child with epiglottitis with severe respiratory distress. The throat should not be inspected because airway obstruction can occur, and steroids would not be done first when the child is in severe respiratory distress.

[jace]

Excellent

[dawsa925]

TYSM