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 ["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.

A. "Schedule a time for your child to receive the pneumococcal vaccine within 2 weeks." B. "Provide your child with their own towel for drying their face and hands at home." C. "Replace your child's toothbrush 24 hours after beginning antibiotic therapy." D. "Your child can return to school 24 hours after their first does of antibiotics." E. "Replace your child's orthodontic appliances prior to beginning antibiotic therapy."

Correct Answer is ["B","C","D"]

Explanation

A. "Schedule a time for your child to receive the pneumococcal vaccine within 2 weeks."

This statement is incorrect. Pharyngitis caused by group A beta-hemolytic streptococci (GABHS) is typically treated with antibiotics, but it does not necessitate pneumococcal vaccination. Pneumococcal vaccination is recommended for other purposes, such as preventing pneumonia and invasive pneumococcal disease.

B. "Provide your child with their own towel for drying their face and hands at home."

This statement is correct. Group A streptococci (GAS) can be transmitted through respiratory droplets or by direct contact with infected secretions. Providing the child with their own towel can help prevent the spread of the infection to other family members.

C. "Replace your child's toothbrush 24 hours after beginning antibiotic therapy."

This statement is correct. It is recommended to replace the child's toothbrush after starting antibiotic therapy to reduce the risk of re-infection with group A streptococci (GAS).

D. "Your child can return to school 24 hours after their first dose of antibiotics."

This statement is correct. After initiating antibiotic therapy for GABHS pharyngitis, the child is usually considered non-contagious and can return to school after completing 24 hours of antibiotic treatment.

E. "Replace your child's orthodontic appliances prior to beginning antibiotic therapy."

This statement is incorrect. There is no specific recommendation to replace orthodontic appliances before starting antibiotic therapy for GABHS pharyngitis unless otherwise advised by a dentist or healthcare provider.

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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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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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Correct Answer is ["B","C","D"]

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