A nurse is assessing a child whose history reveals an upper respiratory illness that has progressed to a persistent cough characterized by an inspiratory whoop. The nurse would suspect which of the following?
Pertussis
Asthma
Bronchiolitis
Acute Laryngotraceobronchitis (LTB)
The Correct Answer is A
A. Pertussis:
Pertussis, commonly known as whooping cough, is caused by the bacterium Bordetella pertussis. It is characterized by a persistent cough with a distinctive "whoop" sound during the inspiratory phase. The cough can be severe and may last for several weeks. The characteristic whooping sound is due to the rapid intake of breath after a coughing episode.
B. Asthma:
Asthma is a chronic respiratory condition characterized by recurrent episodes of wheezing, coughing, and shortness of breath. It is not typically associated with a whooping sound during the inspiratory phase. Asthma symptoms are often triggered by factors such as allergies, exercise, or exposure to irritants.
C. Bronchiolitis:
Bronchiolitis is commonly caused by respiratory syncytial virus (RSV), especially in infants. It presents with symptoms such as cough, wheezing, and respiratory distress. However, it does not involve the characteristic whooping cough sound seen in pertussis.
D. Acute Laryngotracheobronchitis (LTB):
Acute Laryngotracheobronchitis, or croup, is characterized by a barking cough, stridor (a high-pitched sound during inhalation), and respiratory distress. It is common in young children and is often caused by viruses. Unlike pertussis, it does not typically include the distinctive whooping sound.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Teaching the child to take long, slow breaths:
While teaching slow breathing techniques can be helpful in managing anxiety and promoting a sense of calm, it may not directly address the underlying airway inflammation and bronchodilation needed in acute laryngotracheobronchitis.
B. Assisting with racemic epinephrine nebulizer therapy:
Racemic epinephrine is a medication that contains epinephrine, a bronchodilator. Nebulizer therapy with racemic epinephrine helps reduce airway inflammation, allowing for bronchodilation and improved breathing. This is a common intervention for managing acute respiratory distress in conditions like croup.
C. Administering an oral analgesic:
Oral analgesics, such as pain medications, can provide relief from discomfort or pain, but they do not directly address the bronchodilation needed for conditions like acute laryngotracheobronchitis.
D. Administering a corticosteroid:
Corticosteroids have anti-inflammatory properties and can help reduce swelling and inflammation in the airways. By doing so, they contribute to bronchodilation and improved breathing in conditions like croup. Corticosteroids are often used as part of the treatment plan for acute laryngotracheobronchitis.
Correct Answer is ["0.1696"]
Explanation
To calculate the ordered dose by the physician in mg/kg/dose, we need to convert the infant's weight from pounds and ounces to kilograms. One pound is equal to 0.4536 kg and one ounce is equal to 0.02835 kg. Therefore, the infant's weight in kilograms is:
6 x 0.4536 + 3 x 0.02835 = 2.948 kg
The ordered dose by the physician is 0.5 mg IV q 2 hours prn. To find the dose in mg/kg/dose, we divide the dose in mg by the weight in kg:
0.5 / 2.948 = 0.1696 mg/kg/dose
The recommended dosage for a child is 0.1-0.2 mg/kg/dose q2-4 hours prn. The ordered dose by the physician falls within this range, so it is a safe dosage for the infant.
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