The nurse is caring for a toddler with acute laryngotracheobronchitis. Which action aids in bronchodilation to improve breathing for this child?

Teaching the child to take long, slow breaths

Assisting with racemic epinephrine nebulizer therapy

Administering an oral analgesic

Administering a corticosteroid

Answer and Explanation

The Correct Answer is B

A. Teaching the child to take long, slow breaths:

While teaching slow breathing techniques can be helpful in managing anxiety and promoting a sense of calm, it may not directly address the underlying airway inflammation and bronchodilation needed in acute laryngotracheobronchitis.

B. Assisting with racemic epinephrine nebulizer therapy:

Racemic epinephrine is a medication that contains epinephrine, a bronchodilator. Nebulizer therapy with racemic epinephrine helps reduce airway inflammation, allowing for bronchodilation and improved breathing. This is a common intervention for managing acute respiratory distress in conditions like croup.

C. Administering an oral analgesic:

Oral analgesics, such as pain medications, can provide relief from discomfort or pain, but they do not directly address the bronchodilation needed for conditions like acute laryngotracheobronchitis.

D. Administering a corticosteroid:

Corticosteroids have anti-inflammatory properties and can help reduce swelling and inflammation in the airways. By doing so, they contribute to bronchodilation and improved breathing in conditions like croup. Corticosteroids are often used as part of the treatment plan for acute laryngotracheobronchitis.

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Correct Answer is A

Explanation

A. “Bring the child to the emergency room immediately.”

This is the most appropriate recommendation given the symptoms described, including the barking cough, elevated temperature, and blueness around the mouth. These signs may indicate respiratory distress, and immediate medical attention is needed.

B. “Bundle the child up and take her out into the cold for a few minutes. Call back if the exposure to the cold air does not provide relief.”

Taking a child out into the cold is not a recommended intervention for respiratory distress. This action may exacerbate the child's breathing difficulties. The symptoms described require urgent evaluation in a healthcare setting.

C. “Take the child into the steam-filled room for an additional 15 minutes. If there is no relief, bring the child to the emergency room.”

While steam may provide temporary relief for mild respiratory symptoms, the presence of blueness around the mouth suggests a more severe condition. Delaying care by waiting for an additional 15 minutes may not be appropriate in this situation.

D. “Put a cool mist humidifier or vaporizer in the room to see if that relieves the cough. Call back if there’s no relief in an hour.”

Using a cool mist humidifier may be helpful for mild respiratory symptoms, but the severity of the symptoms described, especially blueness around the mouth, indicates a need for immediate medical attention. Waiting for an hour could lead to worsening of the child's condition.

A. Calmly tell the child to stop. B. Distract the child by buying a toy. C. Appear to ignore them. D. Place the child in time-out for 3 min.

Correct Answer is C

Explanation

A. Calmly tell the child to stop:

While remaining calm is important, simply telling the child to stop might not be effective during a tantrum. Toddlers experiencing a meltdown might not respond immediately to verbal commands.

B. Distract the child by buying a toy:

Using material objects to distract a child during a tantrum might reinforce the behavior by rewarding it with something desired. It's also not always feasible to buy a toy instantly.

C. Appear to ignore them:

This strategy might involve not engaging directly with the tantrum, which could sometimes help to de-escalate the situation. However, it's crucial to ensure the child is in a safe environment and to offer support if necessary.

D. Place the child in time-out for 3 min:

Time-out can be a useful method for calming down a child. However, its effectiveness depends on the child's age, temperament, and the consistency of applying this method. Time-out might not be suitable for all children, especially for a 2-year-old who might not fully understand the concept.

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The nurse is caring for a toddler with acute laryngotracheobronchitis. Which action aids in bronchodilation to improve breathing for this child?

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