A nurse in the emergency department is caring for a preschooler who has epiglottitis. Which of the following actions should the nurse take?

Place the child in a left lateral position.

Obtain a specimen from the child's throat for a culture.

Inspect the child's throat with a padded tongue depressor.

Initiate droplet precautions for the child.

Answer and Explanation

The Correct Answer is D

A. Place the child in a left lateral position: Placing the child in a left lateral position is not the priority action for a preschooler with epiglottitis. Epiglottitis is a potentially life-threatening condition characterized by inflammation and swelling of the epiglottis, which can rapidly progress to airway obstruction. The priority is to maintain a patent airway and ensure adequate oxygenation.

B. Obtain a specimen from the child's throat for a culture: While obtaining a throat culture may be necessary to identify the causative organism and guide antibiotic therapy, it is not the immediate priority in the management of epiglottitis. Airway management and stabilization take precedence.

C. Inspect the child's throat with a padded tongue depressor: Direct visualization of the throat with a padded tongue depressor is contraindicated in a child with suspected epiglottitis. This action can trigger a gag reflex and potentially cause airway obstruction or exacerbate respiratory distress. Epiglottitis is a medical emergency, and any manipulation of the airway should be performed cautiously by experienced healthcare providers in a controlled setting.

D. Initiate droplet precautions for the child: Droplet precautions are appropriate for a child with suspected or confirmed epiglottitis due to the risk of transmission of the causative organism, usually Haemophilus influenzae type B (Hib), through respiratory droplets. However, the immediate priority is to secure the airway and provide respiratory support. Once the child's airway is stabilized, appropriate infection control measures, including droplet precautions, should be implemented to prevent the spread of infection to others.

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Correct Answer is D

Explanation

A. Initiate an infusion of IV fluids:

Administering IV fluids may be necessary to maintain hydration and support circulation, but it is not the first action to take in managing status asthmaticus. In this acute situation, the priority is to address airway obstruction and respiratory distress.

B. Obtain a blood specimen for ABG analysis:

Obtaining arterial blood gas (ABG) analysis can provide valuable information about the child's respiratory status, including oxygenation and acid-base balance. However, it is not the first action to take in managing status asthmaticus.

C. Administer a dose of an IV corticosteroid:

Administering systemic corticosteroids (such as IV hydrocortisone or methylprednisolone) is a crucial intervention in managing status asthmaticus to reduce airway inflammation and improve respiratory function. However, it is not the first action to take.

D. Apply humidified oxygen:

This is the correct action to take first. Applying humidified oxygen helps improve oxygenation and relieve bronchospasm by providing supplemental oxygen to the child's lungs. Oxygen therapy is essential in managing respiratory distress associated with status asthmaticus and should be initiated promptly.

A. "Hyperextend your child's head for 5 minutes following a seizure." B. "Immediately following a seizure, give your child 6 ounces of water." C. "Following a seizure, record the length and characteristics of your child's seizure." D. "Administer rectal diazepam to your child following a seizure." E. "Call for emergency medical services if the size of your child's pupils are unequal after a seizure."

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

Explanation

A. "Hyperextend your child's head for 5 minutes following a seizure."

This instruction is incorrect. Hyperextending the head after a seizure is not recommended and could potentially cause harm. Instead, it's important to ensure that the child's airway is clear and maintain a safe and comfortable position.

B. "Immediately following a seizure, give your child 6 ounces of water."

This instruction is not necessary unless the child specifically requests water or appears to be dehydrated. It's important to focus on ensuring the child's safety and comfort immediately after a seizure.

C. "Following a seizure, record the length and characteristics of your child's seizure."

This instruction is correct. Keeping a record of the length and characteristics of the child's seizures can provide valuable information to healthcare providers for managing the child's epilepsy and adjusting treatment as needed.

D. "Administer rectal diazepam to your child following a seizure."

This instruction may be appropriate in some cases, particularly if the child's seizures are prolonged or if they have a history of status epilepticus. However, the administration of rectal diazepam should be done according to the healthcare provider's instructions and with proper training.

E. "Call for emergency medical services if the size of your child's pupils are unequal after a seizure."

This instruction is correct. Unequal pupil size (anisocoria) after a seizure could indicate a serious underlying condition and should prompt immediate medical evaluation. It's important for the parents to be aware of this potential sign of concern and to seek prompt medical attention if it occurs.

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A nurse in the emergency department is caring for a preschooler who has epiglottitis. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

A home health nurse is providing teaching about postseizure management to the parents of a school-age child who has epilepsy and experiences tonic-clonic seizures. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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

Explanation

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