A 3-year-old child is brought to the emergency department with a barking cough, stridor, and difficulty breathing.
The child's oxygen saturation is 92%.
The nurse assesses the child's respiratory status and determines that the child has moderate croup.
Which of the following statements by the nurse is most appropriate?
"We need to get you started on a ventilator so you can breathe easier.”..
"I'm going to give you some medicine to help your cough and make it easier to breathe.”..
"I'm going to take you to the ICU so we can monitor your breathing more closely.”..
"We're going to take you home now, and your parents can take care of you.”..
The Correct Answer is B
Choice A rationale:
Placing the child on a ventilator might be necessary in severe cases of croup, but it should not be the first action taken.
In this scenario, the child has moderate croup, so less invasive interventions should be attempted first.
Choice B rationale:
Administering medication to help the child's cough and breathing is an appropriate first step in managing moderate croup.
Nebulized epinephrine or corticosteroids are commonly used to reduce airway inflammation and relieve respiratory distress in croup.
This intervention can be effective in improving the child's symptoms and overall condition.
Choice C rationale:
Transferring the child to the ICU for closer monitoring is not immediately necessary in this case of moderate croup.
Such a step might be considered if the child's condition worsens despite initial interventions or if there are signs of severe respiratory distress.
Choice D rationale:
Discharging the child home without appropriate treatment and monitoring would be unsafe, given the child's symptoms and oxygen saturation level.
Immediate intervention and observation are required to ensure the child's respiratory status improves.
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Correct Answer is D
Explanation
Choice A rationale:
This statement does not indicate a complete understanding of croup.
Croup is not just a cold that affects the throat; it specifically involves inflammation of the upper airway.
Choice B rationale:
This statement acknowledges that croup can be serious but usually resolves on its own.
While this is true, it does not encompass the key symptoms and actions the parent should take if the child's condition worsens.
Choice C rationale:
This statement addresses general cold symptoms but does not specifically mention the characteristic symptoms of croup, such as barking cough, hoarseness, and stridor.
Choice D rationale:
This is The correct answer.
It shows an understanding of the symptoms of croup, particularly the mention of having trouble breathing, which is a sign of severe croup that requires medical attention.
Parents should seek emergency medical care if their child experiences difficulty breathing due to croup.
Providing this information demonstrates a comprehensive understanding of the condition.
Correct Answer is C
Explanation
The nurse should assess the degree of airway obstruction to determine the severity of respiratory distress.
Choice A rationale:
Assessing the child's height and weight is important for overall health assessment but does not specifically determine the severity of respiratory distress in croup.
Respiratory distress is primarily evaluated by assessing airway patency, effort of breathing, and oxygenation.
Choice B rationale:
The child's vaccination history is crucial for preventing certain infectious diseases, but it does not directly assess the severity of respiratory distress in croup.
Croup is commonly caused by viral infections such as parainfluenza viruses.
Choice C rationale:
Assessing the degree of airway obstruction is essential in determining the severity of respiratory distress in croup.
Children with croup often present with stridor, a high-pitched sound heard during inspiration, indicating partial airway obstruction.
The severity of stridor, along with signs of increased work of breathing, provides valuable information about the child's respiratory status.
Choice D rationale:
The child's social activities are not directly related to the assessment of respiratory distress in croup.
While social history is important in a comprehensive nursing assessment, it does not provide specific information about the severity of airway obstruction in croup.
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