A 2-year-old boy is in severe respiratory distress. The child is ...

[Bob-Dole]

A 2-year-old boy is in severe respiratory distress. The child is drooling and has labored breathing. Stridor is heard. RR is 42 breaths/min and HR is 148 beats/min. What should be done next?
 
  a. Intubate.
  b. Provide 100 oxygen on nonrebreather mask.
  c. Administer racemic epinephrine.
  d. Place on CPAP with low PSV.

Question 2

What therapy has been shown to reduce the rate of loss of lung function in patients with cystic fibrosis?
 
  a. High doses of ibuprofen
  b. Continuous oxygen therapy
  c. Corticosteroids
  d. Inhaled DNase

[shewald78]

Answer to Question 1

ANS: A
The clinical picture, particularly the age, level of distress, stridor, and drooling, suggests that this patient apparently has epiglottitis, a severe swelling of the tissue around the glottis. Given the potential for additional swelling and complete airway closure, this patient should be intubated for airway protection.

Answer to Question 2

ANS: A
High doses of the anti-inflammatory drug ibuprofen reduce the rate of lung function loss in pa-tients younger than 13 years.