A nurse is assisting with a parenting class and is approached by a parent of a 2-year-old toddler who asks what to do when the toddler throws a tantrum. Which of the following instructions should the nurse give?

A. “Bring the child to the emergency room immediately.”

This is the most appropriate recommendation given the symptoms described, including the barking cough, elevated temperature, and blueness around the mouth. These signs may indicate respiratory distress, and immediate medical attention is needed.

B. “Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”

Taking a child out into the cold is not a recommended intervention for respiratory distress. This action may exacerbate the child's breathing difficulties. The symptoms described require urgent evaluation in a healthcare setting.

C. “Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”

While steam may provide temporary relief for mild respiratory symptoms, the presence of blueness around the mouth suggests a more severe condition. Delaying care by waiting for an additional 15 minutes may not be appropriate in this situation.

D. “Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”

Using a cool mist humidifier may be helpful for mild respiratory symptoms, but the severity of the symptoms described, especially blueness around the mouth, indicates a need for immediate medical attention. Waiting for an hour could lead to worsening of the child's condition.

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.