During the recovery stages of croup, a nurse should explain which intervention to parents?
Limiting oral fluid intake
Recognizing signs of respiratory distress
Providing three nutritious meals per day
Allowing the child to go to the playground
The Correct Answer is B
During the recovery stages of croup, the airway inflammation is decreasing, but the child may still be at risk for sudden worsening of symptoms, particularly at night or with viral reinfection. Parents need to be able to monitor for early signs of respiratory distress to ensure prompt intervention if symptoms recur.
Rationale for correct answer:
2. Recognizing signs of respiratory distress: Parents should be taught to observe for stridor at rest, retractions, nasal flaring, cyanosis, or increased work of breathing. Early recognition allows timely medical evaluation and prevents potential airway compromise. Education on when to seek immediate care is a key part of discharge teaching after croup.
Rationale for incorrect answers:
1. Limiting oral fluid intake: This is inappropriate since adequate hydration helps thin secretions and support recovery. Fluids should not be restricted.
3. Providing three nutritious meals per day: While nutrition is important, meal frequency is not critical during acute recovery. The priority is airway monitoring and hydration, not strict meal scheduling.
4. Allowing the child to go to the playground: Vigorous activity can increase respiratory demand and aggravate airway inflammation. Outdoor play should be gradual and based on the child’s energy and breathing after full recovery.
Take home points
- The primary focus during recovery from croup is airway safety and early recognition of respiratory distress.
- Educate parents on signs of worsening stridor, retractions, and cyanosis.
- Ensure children remain hydrated, avoid strenuous activity, and follow up with the healthcare provider as needed.
- Most children recover fully with supportive care, but vigilance during the first few days post-illness is crucial.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Croup (laryngotracheobronchitis)severity varies based on age, airway size, and immune response. Children under 3 years have smaller, more pliable airways, which are easily obstructed by inflammation and edema. Their immune systems are still developing, which may contribute to more pronounced symptoms and higher risk of respiratory distress compared with older children.
Rationale for correct answer:
4. “Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed.”This response is factually correct and helps the parent understand why severity varies among children. It reassures the parent that the child’s hospitalization is based on age-related risk and airway safety, not neglect or unusual illness. Provides education and context without blaming the parent.
Rationale for incorrect answers:
1. “Some children just react differently to viruses. It is best to treat each child as an individual.”While partially true, it is too vague and does not explain why younger children are at higher risk for severe croup.
2. “Younger children have wider airways that make it easier for bacteria to enter and colonize.”Younger children have narrower, not wider, airways, which contributes to obstruction, not bacterial colonization. Croup is viral, not bacterial in most cases.
3. “Younger children have short and wide eustachian tubes, making them more susceptible to respiratory infections.”This is true for otitis media, but not relevant to croup, which affects the larynx and trachea, not the middle ear.
Take home points
- Age <3 years is a major risk factor for severe croup due to small, easily obstructed airways and immature immune systems.
- Parents should understand that hospitalization is for airway safety and monitoring, not necessarily because the virus is more severe.
- Education and reassurance help reduce parental anxiety and improve adherence to care recommendations.
Correct Answer is D
Explanation
Acute laryngotracheobronchitis (croup)is a viral upper airway infectioncausing inflammation of the larynx, trachea, and bronchi. It typically affects toddlers (6 months–3 years) and presents with barking cough, stridor, respiratory distress, and agitation or anxiety due to difficulty breathing
Rationale for correct answer:
4. Fear or anxiety related to dyspnea and noisy breathing: The child’s labored, noisy breathing is distressing for both the child and the family. Anxiety can aggravate airway obstruction because crying increases airway resistance in a partially obstructed upper airway. Addressing emotional needs and providing reassurance is essential alongside airway management.
Rationale for incorrect answers:
1. Potential for impaired family coping: While family coping may be affected, it is secondary to the immediate concern of child’s respiratory distress.
2. Impaired growth and development delays related to acute onset of illness: Acute croup is short-term, and mild illness does not significantly impact growth or development.
3. Impaired social isolation related to confinement in hospital: Hospitalization may temporarily affect socialization, but it is not a priority concern compared with airway compromise and family anxiety.
Take home points
- Airway distress and fear are closely linked in toddlers with croup; managing emotional and physical needs simultaneously is critical.
- Nursing interventions include:
- Calm reassurance to the child and parents
- Upright positioning to ease breathing
- Minimizing agitation (avoid invasive procedures unless necessary)
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