A nurse is caring for a child with croup in the hospital.
The child is receiving humidified air and nebulized racemic epinephrine.
The nurse monitors the child's respiratory status closely.
Which of the following findings would indicate to the nurse that the child's condition is worsening?

The nurse should assess the degree of airway obstruction to determine the severity of respiratory distress.

Choice A rationale:

Assessing the child's height and weight is important for overall health assessment but does not specifically determine the severity of respiratory distress in croup.

Respiratory distress is primarily evaluated by assessing airway patency, effort of breathing, and oxygenation.

Choice B rationale:

The child's vaccination history is crucial for preventing certain infectious diseases, but it does not directly assess the severity of respiratory distress in croup.

Croup is commonly caused by viral infections such as parainfluenza viruses.

Choice C rationale:

Assessing the degree of airway obstruction is essential in determining the severity of respiratory distress in croup.

Children with croup often present with stridor, a high-pitched sound heard during inspiration, indicating partial airway obstruction.

The severity of stridor, along with signs of increased work of breathing, provides valuable information about the child's respiratory status.

Choice D rationale:

The child's social activities are not directly related to the assessment of respiratory distress in croup.

While social history is important in a comprehensive nursing assessment, it does not provide specific information about the severity of airway obstruction in croup.

The nurse should assess the child's vital signs and listen to his lungs.

Choice A rationale:

Assessing vital signs, including heart rate, respiratory rate, oxygen saturation, and temperature, is essential in evaluating the child's overall condition and the severity of respiratory distress.

Listening to the child's lungs can help identify abnormal breath sounds, such as stridor or wheezing, which are common in croup.

This information guides further interventions and helps determine the appropriate level of care.

Choice B rationale:

While croup can cause respiratory distress, not every case requires an emergency room visit.

The severity of symptoms, including the child's ability to breathe and oxygenate, should guide the decision to seek emergency care.

In this scenario, assessing vital signs and lung sounds is the initial appropriate action.

Choice C rationale:

Croup is a treatable condition, and there are specific interventions, such as providing humidified air and corticosteroids, that can alleviate symptoms and prevent complications.

It is incorrect to tell the parent that there is nothing that can be done for croup.

Medical intervention can significantly improve the child's condition.

Choice D rationale:

Croup is primarily caused by viral infections, not bacterial infections.

Administering antibiotics without confirming a bacterial infection is inappropriate and contributes to antibiotic resistance.