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.”..

Answer and Explanation

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 ["A","B","C","E"]

Explanation

Choice A rationale:

Administering oxygen therapy is essential in cases of severe croup where the child has difficulty breathing.

Oxygen therapy helps ensure adequate oxygenation, which is crucial in managing respiratory distress.

Choice B rationale:

Positioning the child upright facilitates breathing by allowing the airways to remain open and reducing airway obstruction.

This position helps alleviate symptoms like stridor and allows the child to breathe more comfortably.

Choice C rationale:

Providing humidified air helps loosen secretions and makes it easier for the child to breathe.

Humidification can reduce airway irritation and soothe the inflamed throat, providing relief from croup symptoms.

Choice D rationale:

This choice is incorrect because encouraging the child to drink plenty of fluids is generally good advice for any illness but is not specific to croup.

While it is essential to keep the child hydrated, it is not a direct nursing intervention for managing croup symptoms.

Choice E rationale:

Monitoring the child's respiratory status closely is crucial in assessing the effectiveness of the interventions and identifying any signs of respiratory distress.

Close monitoring allows nurses to make timely decisions and take appropriate actions to maintain the child's respiratory function.

A. Continue to monitor the child's respiratory status. B. Administer oxygen therapy as needed. C. Prepare to administer nebulized epinephrine. D. Notify the physician immediately.

Correct Answer is C

Explanation

Choice A rationale:

Continuing to monitor the child's respiratory status may not be the best action in this situation, as the child's respiratory status is worsening and they are becoming increasingly agitated.

Immediate intervention is required to alleviate the child's distress.

Choice B rationale:

Administering oxygen therapy as needed is a supportive measure in respiratory distress situations, but in the case of severe croup with worsening respiratory status and agitation, nebulized epinephrine is the treatment of choice to reduce airway inflammation and improve breathing.

Choice C rationale:

Nebulized epinephrine is the primary treatment for severe croup as it helps reduce upper airway edema, relieve stridor, and improve respiratory distress.

It acts by causing vasoconstriction, which reduces swelling in the upper airway, making breathing easier for the child.

Therefore, preparing to administer nebulized epinephrine is the most appropriate action in this situation.

Choice D rationale:

Notifying the physician immediately is essential, but immediate intervention to improve the child's respiratory distress is also necessary.

Nebulized epinephrine should be administered promptly to alleviate the child's symptoms and prevent further deterioration.

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Naxlex Comprehensive Predictor Exams

Select all that apply.Which of the following are nursing interventions for a child with croup?

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is caring for a child with croup.The child's respiratory status is worsening, and they are becoming increasingly agitated.What action should the nurse take?

Correct Answer is C

Explanation

A nurse is educating parents of a child with croup about the signs and symptoms.Which clinical manifestations should the nurse include in the teaching? Select all that apply.

A nurse is teaching a parent about the signs and symptoms of croup.Which of the following statements should the nurse include in the teaching?Select all that apply.

A nurse is educating a parent about the prevention of croup.Which of the following statements should the nurse include in the teaching?

A nurse is assessing a 2-year-old child with croup.The child's mother states that the child has had a barking cough for 2 days, which is worse at night.The child also has a fever and is hoarse.Which of the following statements by the nurse is most appropriate?

A nurse is teaching the parents of a child with croup about home care management.The nurse explains that it is important to keep the child hydrated and to provide humidified air.Which of the following statements by the parent indicates that they understand the nurse's instructions?

A nurse is caring for a child with croup and needs to implement nursing interventions.What interventions are appropriate for a child with croup? Select all that apply.

A nurse is performing a nursing assessment of a child with croup.What should the nurse assess to determine the severity of respiratory distress?