A nurse in an emergency department is caring for a 3-year-old child who has suspected epiglottitis.
Which of the following actions should the nurse take?
Prepare to assist with intubation.
Prepare a cool mist tent.
Suction the child's oropharynx.
Obtain a throat culture.
The Correct Answer is A
Choice A rationale:
Preparing to assist with intubation is the appropriate action for a nurse caring for a child with suspected epiglottitis. Epiglottitis is a medical emergency where the airway can become severely compromised due to inflammation of the epiglottis. Intubation ensures a secure airway, allowing the child to breathe and preventing respiratory distress.
Choice B rationale:
Preparing a cool mist tent is not the priority in suspected epiglottitis. While humidified air can provide comfort for respiratory distress, it does not address the potential for airway obstruction. Intubation takes precedence in this critical situation.
Choice C rationale:
Suctioning the child's oropharynx may worsen the condition in suspected epiglottitis. Suctioning can stimulate the epiglottis, triggering a spasm and further obstructing the airway. Intubation is the primary intervention to secure the airway safely.
Choice D rationale:
Obtaining a throat culture is not the immediate action in suspected epiglottitis. While a throat culture may confirm the diagnosis, the priority is securing the airway to prevent respiratory distress and hypoxia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Offering small amounts of clear liquids 6 hours following surgery is generally appropriate, but it doesn't specifically address the child's pain management. Pain control is essential postoperatively, and the best approach is to administer analgesics as prescribed by the healthcare provider.
Choice B rationale:
Applying a warm compress to the operative site once daily can provide comfort and may help reduce localized pain or swelling. However, this alone might not be sufficient for pain management, especially in the immediate postoperative period.
Choice C rationale:
(Correct Choice) Administering analgesics on a scheduled basis for the first 24 hours is essential for managing postoperative pain effectively. Pain can interfere with the child's recovery, breathing, and overall well-being. Scheduled pain medications ensure a consistent level of pain relief, allowing the child to rest and recover more comfortably.
Choice D rationale:
Cromolyn nebulized solution is used to prevent asthma symptoms and allergic reactions. It is not typically indicated for postoperative pain management. Providing appropriate analgesics, as prescribed, is the standard of care for managing pain in a postoperative child.
Correct Answer is A
Explanation
Choice A rationale:
"Uneven shoulder and pelvic heights." This is the correct answer. Uneven shoulder and pelvic heights, along with an asymmetrical appearance of the spine when viewed from the back, are clinical manifestations of scoliosis. Scoliosis is a sideways curvature of the spine that often develops during the growth spurt before puberty. Screening for scoliosis typically involves assessing the alignment of the spine and looking for these asymmetries.
Choice B rationale:
Exaggerated curvature of the sacrum is not a typical sign of scoliosis. Scoliosis primarily affects the upper back and can cause a side-to-side curvature of the spine, not the sacrum.
Choice C rationale:
Limited range-of-motion of the hips is not a specific indicator of scoliosis. Restricted hip movement might suggest other musculoskeletal issues but is not directly related to scoliosis.
Choice D rationale:
Mild pain in the hip region is not a characteristic symptom of scoliosis. While scoliosis can cause discomfort, it typically manifests as back pain, not specifically in the hip region. Pain symptoms can vary widely among individuals and might not be present in all cases of scoliosis.
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