A 5-month-old child is seen in the ER with a diagnosis of croup. What should the nurse include in her teaching about helping the child's cough at night?

Return to the ED immediately for a cough that gets worse at night

Take the child into a steamy hot bathroom for 15 minutes.

Give the child warm liquids to soothe the throat

Give the child over-the-counter cough suppressants

Answer and Explanation

The Correct Answer is B

A. Return to the ED immediately for a cough that gets worse at night: While worsening symptoms should be monitored, mild nighttime worsening of croup is common. Immediate return to the ED is not necessary unless there are signs of respiratory distress like stridor at rest, retractions, or cyanosis.

B. Take the child into a steamy hot bathroom for 15 minutes: Exposure to humidified air can help loosen mucus and reduce airway inflammation, easing the barking cough associated with croup. This home remedy is safe and effective for nighttime symptoms in mild cases.

C. Give the child warm liquids to soothe the throat: Infants under 6 months should not be given liquids other than breast milk or formula unless specifically instructed by a provider. Warm liquids also pose a risk of burns or aspiration in young infants.

D. Give the child over-the-counter cough suppressants: OTC cough suppressants are not recommended for children under 6 years old due to lack of proven benefit and risk of side effects. They can suppress the protective cough reflex and should be avoided in infants.

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Correct Answer is C

Explanation

A. Obstructed or narrowed airways as in bronchospasm:Bronchospasm typically causes wheezing, a high-pitched musical sound heard mainly on expiration due to narrowed airways. It does not produce the popping or crackling noises.

B. Inflammation of the pleura:Pleural inflammation leads to pleural friction rubs, which are grating or creaking sounds heard during both inspiration and expiration. These sounds are lower-pitched and different from the fine or coarse crackles associated with fluid.

C. Fluid accumulation in the lungs:Popping noises, or crackles (rales), are classic signs of fluid in the alveoli, often due to conditions like pulmonary edema or pneumonia. These sounds are usually heard on inspiration but may also occur on expiration in severe cases.

D. Obstruction due to secretions blocking the airway:Secretions cause rhonchi, which are coarse, low-pitched sounds that may clear with coughing. These differ in character from the fine or coarse crackles heard with fluid accumulation in lung tissue.

A. Increased protein B. Soft, bland diet C. Clear liquid D. The client should be held NPO until symptoms improve

Correct Answer is C

Explanation

A. Increased protein:While protein supports immune function, high-protein diet is not the priority in the acute phase of an upper respiratory infection. The client may also have decreased appetite, sore throat, or nasal congestion, making solid food difficult to consume.

B. Soft, bland diet:This may be suitable for gastrointestinal issues or during recovery from oral or throat surgery, but it is not specifically indicated for upper respiratory infections. It also doesn't provide adequate hydration, which is a key focus during respiratory illness.

C. Clear liquid:A clear liquid diet helps keep the client hydrated, soothes throat irritation, and is easier to tolerate during acute illness. Broths, juices, teas, and electrolyte fluids help thin mucus secretions and prevent dehydration, which supports symptom management and recovery.

D. The client should be held NPO until symptoms improve:There is no reason to keep a client with an upper respiratory infection NPO unless they are experiencing vomiting or altered consciousness. Doing so would risk dehydration and slow recovery.

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A 5-month-old child is seen in the ER with a diagnosis of croup. What should the nurse include in her teaching about helping the child's cough at night?

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Naxlex Comprehensive Predictor Exams

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