A nurse is instilling otic drops into an 18-month-old child's ears. Which of the following methods should the nurse use?

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.

A. Green zone reading on peak expiratory flow meter:

A green zone reading on a peak expiratory flow meter indicates that the child's peak expiratory flow rate (PEFR) is within the normal or stable range. This would not typically be indicative of an exacerbation of asthma. In fact, a green zone reading suggests that asthma is well-controlled.

B. Rhinitis:

Rhinitis, or inflammation of the nasal mucosa, is a common symptom in individuals with asthma, but it is not necessarily indicative of an exacerbation of asthma. Rhinitis can occur due to allergic or non-allergic triggers and may be present even when asthma is well-controlled.

C. Axillary temperature of 37.2°C (99°F):

An axillary temperature of 37.2°C (99°F) is within the normal range for body temperature and is not indicative of an exacerbation of asthma. While fever can occur during exacerbations of asthma, it is not a universal symptom and may be absent in some cases.

D. Hacking, nonproductive cough:

This is the correct option. A hacking, nonproductive cough is a common symptom of asthma exacerbation. During an exacerbation, the airways become inflamed and constricted, leading to coughing. The cough may be dry and unproductive, and it is often worse at night or early in the morning.