The nurse in the emergency department is caring for a child who appears extremely ill with a high fever, unable to control their oral secretions. with voice hoarseness and inspiratory stridor and inspiratory sternal retractions while breathing. The nurse suspects epiglottitis. Which would the nurse do next?
Contact the assigned emergency room physician to evaluate the need for an advanced airway
Administer intravenous corticosteroids
Obtain a throat culture
inspect the throat to obtain further data to support the diagnosis
The Correct Answer is A
A. Contact the assigned emergency room physician to evaluate the need for an advanced airway
Explanation:
Epiglottitis is a medical emergency that can rapidly progress to airway obstruction. The classic signs and symptoms include a high fever, difficulty swallowing, voice hoarseness, inspiratory stridor, and sternal retractions. Immediate intervention may be necessary to secure the airway. Therefore, contacting the emergency room physician to evaluate the need for an advanced airway (such as intubation) is a priority.
B. Administer intravenous corticosteroids
Explanation: While corticosteroids may be used in the management of epiglottitis to reduce airway inflammation, securing the airway is the priority in the acute phase. Corticosteroids would typically be administered after securing the airway.
C. Obtain a throat culture
Explanation: Obtaining a throat culture is not the immediate priority in the case of suspected epiglottitis. Prompt intervention to secure the airway takes precedence over diagnostic tests.
D. Inspect the throat to obtain further data to support the diagnosis
Explanation: Direct visualization of the throat (inspection) may exacerbate the airway obstruction and is not recommended in the acute management of suspected epiglottitis. The priority is to secure the airway while minimizing agitation and discomfort for the child. Diagnostic procedures, such as obtaining a throat culture, can be considered after the airway is stabilized.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "This test will confirm if your child had a recent streptococcal infection."
Explanation:
The anti-streptolysin O (ASO) titer is a blood test used to detect the presence of antibodies against streptolysin O, a toxin produced by group A Streptococcus bacteria. A rise in ASO titers indicates a recent streptococcal infection. It does not confirm rheumatic fever directly but helps in identifying a recent streptococcal infection, which is a predisposing factor for rheumatic fever.
B. "This test will indicate if your child has rheumatic fever."
Explanation: While a positive ASO titer may suggest a recent streptococcal infection, it does not directly indicate rheumatic fever. The diagnosis of rheumatic fever involves a combination of clinical criteria, including evidence of a recent streptococcal infection, along with specific signs and symptoms.
C. "This test will confirm if your child has immunity to streptococcal bacteria."
Explanation: The ASO titer does not measure immunity to streptococcal bacteria. It specifically detects antibodies produced in response to a recent streptococcal infection.
D. "This test will indicate if your child has a therapeutic blood level of an aminoglycoside."
Explanation: The ASO titer is not used to monitor therapeutic blood levels of aminoglycosides. It is specific to detecting antibodies related to streptococcal infections and is not related to aminoglycoside therapy.
Correct Answer is C
Explanation
A. A highly pruritic profuse macule to papule rash on the trunk.
Explanation: This description does not align with the typical presentation of erythema infectiosum. The rash in fifth disease is not highly pruritic, and the initial characteristic is the "slapped face" appearance.
B. A discrete pinkish red maculopapular rash that is spreading to the trunk.
Explanation: While erythema infectiosum can involve a discrete rose-pink maculopapular rash on the trunk and limbs, the key initial characteristic is the "slapped face" appearance.
C. An erythema on the face that has a "slapped face appearance."
Explanation:
Erythema infectiosum, caused by the parvovirus B19, is commonly known as fifth disease. The initial rash often presents with a distinctive "slapped face" appearance, characterized by erythema (redness) on the cheeks, resembling a slapped appearance. Subsequently, a discrete rose-pink maculopapular rash may develop on the trunk and limbs.
D. A discrete rose-pink maculopapular rash on the trunk.
Explanation: This description aligns with the later stages of the rash in erythema infectiosum. However, the initial characteristic is the "slapped face" appearance on the face.
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