A 2-year-old boy is brought to the emergency department with a barking cough, hoarseness, and inspiratory stridor.
His parents report that he has been sick for 2 days and that his symptoms have been getting worse.
The boy's vital signs are as follows: temperature 102°F (38.9°C), heart rate 120 beats/minute, respiratory rate 28 breaths/minute, and oxygen saturation 95% on room air.
Physical examination reveals a well-developed, well-nourished boy in moderate respiratory distress.
He is using accessory muscles of respiration and has intercostal retractions.
His lungs are clear to auscultation.
Which of the following statements by the nurse is most appropriate?
"Your son has croup.
"Your son has epiglottitis.
"Your son has asthma.
"Your son has pneumonia.
The Correct Answer is A
The correct answer is choice A, “Your son has croup.”
Choice A rationale:
The symptoms described, including a barking cough, hoarseness, and inspiratory stridor, are classic signs of croup. Croup is a common respiratory condition in young children that leads to swelling of the larynx and trachea, causing the characteristic cough and stridor.
Choice B rationale:
While epiglottitis can present with respiratory distress, it is more commonly associated with high fever, severe sore throat, drooling, and difficulty swallowing, rather than a barking cough and stridor.
Choice C rationale:
Asthma typically presents with wheezing and difficulty exhaling, not the barking cough and inspiratory stridor seen in croup. Additionally, asthma is often associated with a history of allergies or atopic conditions, which are not mentioned in the scenario.
Choice D rationale:
Pneumonia usually presents with fever, cough producing phlegm, and crackles or wheezes on lung auscultation. The clear lungs on auscultation and the absence of productive cough make pneumonia less likely in this case.
In summary, the presentation of a barking cough, hoarseness, and inspiratory stridor in a young child who is in moderate respiratory distress with a recent onset of symptoms is most indicative of croup. This is supported by the age of the child and the clinical findings, which align with the typical presentation of croup.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Nursing interventions for a child with croup include providing cool mist humidification, administering bronchodilators, and administering corticosteroids.
Choice A rationale:
Administering antibiotics is not a standard intervention for croup unless there is a secondary bacterial infection present.
Croup is typically caused by viral infections, so antiviral medications might be considered if the cause is identified as a specific virus.
However, antibiotics do not directly address the symptoms of croup.
Choice B rationale:
Providing cool mist humidification is appropriate for a child with croup.
Cool mist helps soothe the inflamed airways and can alleviate respiratory distress by reducing airway edema.
Moist air can make breathing easier for the child.
Choice C rationale:
Administering bronchodilators can be beneficial in the treatment of croup, especially if there is evidence of bronchoconstriction.
Bronchodilators help dilate the airways, making breathing easier for the child.
This intervention can be particularly useful if the child is experiencing wheezing in addition to stridor.
Choice D rationale:
Administering corticosteroids, such as dexamethasone, is a common and evidence-based intervention for croup.
Corticosteroids reduce airway inflammation and edema, leading to symptom improvement.
A single dose of oral corticosteroids is often sufficient to manage croup symptoms effectively.
Choice E rationale:
Encouraging the child to cough loudly is not a recommended intervention for croup.
Coughing forcefully may exacerbate airway irritation and inflammation, worsening the child's symptoms.
Instead, interventions should focus on reducing airway edema and providing respiratory support.
Correct Answer is C
Explanation
Choice A rationale:
While giving the child plenty of water and juice is important for hydration, this statement does not address the specific management of croup symptoms.
Choice B rationale:
Running a hot shower and letting the child sit in the bathroom can create a steamy environment, but it is not the most effective way to provide humidified air.
A cool mist humidifier is a more controlled and efficient method for delivering humidified air to the child.
Choice C rationale:
This is The correct answer.
Using a cool mist humidifier in the child's bedroom is an appropriate way to provide humidified air, which can help ease breathing difficulties associated with croup.
Cool mist humidifiers add moisture to the air without heating it, making it easier for the child to breathe and reducing throat irritation.
Choice D rationale:
Giving the child a warm bath may provide some comfort but does not specifically address the need for humidified air, which is crucial in managing croup symptoms.
Providing humidified air helps soothe the inflamed airways and reduce respiratory distress associated with croup.
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