The parent of an 18-month-old-child calls the child’s primary health-care provider and states, “My child coughed all night long. She doesn’t seem to be too sick, and she has no temperature. What can I do to help her and the rest of us to sleep tonight?” Which of the following responses is appropriate for the nurse to make?
“It often helps to promote sleep by putting a steam vaporizer right next to the head of the baby’s crib.”
“There are a number of very good nonprescription cough and cold medications at the
pharmacy.”
“You could try raising the head of the baby’s crib by putting books under the crib’s front feet.”
“The baby probably needs antibiotics so let’s make an appointment for her for this afternoon.”
The Correct Answer is C
A nighttime cough in a young child without fever often indicates mild upper respiratory irritation or postnasal drip. Non-pharmacologic comfort measures can help reduce coughing and promote better sleep without unnecessary medication.
Rationale for correct answer:
3. Raising the head of the baby’s crib can help reduce coughing by promoting drainage of nasal secretions and reducing postnasal drip that irritates the throat. This simple intervention is safe, non-invasive, and can improve the child’s comfort and sleep quality.
Rationale for incorrect answers:
1. Steam vaporizers placed too close can cause burns or be a safety hazard. Cold mist humidifiers used properly can help, but the placement should be safe and not directly next to the child’s face or crib.
2. Nonprescription cough and cold medicines are not recommended for children under 2 years due to lack of efficacy and potential serious side effects. The FDA advises against their use in infants and toddlers.
4. Antibiotics are not appropriate without signs of bacterial infection such as fever or purulent symptoms. Most coughs in toddlers are viral and self-limiting.
Take home points
- For mild nighttime cough without fever in toddlers, non-pharmacologic measures like elevating the head of the crib can improve comfort.
- Avoid over-the-counter cough and cold medicines in children under 2 due to safety concerns.
- Antibiotics should not be prescribed unless bacterial infection is clearly suspected.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Croup (laryngotracheobronchitis)is a viral infectioncommonly caused by the parainfluenza virusthat causes inflammation and narrowing of the larynx, trachea, and bronchi, leading to upper airway obstruction. Typical signs include barking cough, inspiratory stridor, and hoarseness. Nebulized treatmentssuch as racemic epinephrinehelp reduce airway edemaand ease breathing.
Rationale for correct answer:
1. During naptime: Administering the nebulizer while the child is calm or asleep reduces agitation, crying, and airway stress, which can worsen obstruction in croup. Ensures effective delivery of the medication without struggle or additional respiratory distress. Children are often more tolerant of nebulization when relaxed, which improves outcomes.
Rationale for incorrect answers:
2. During playtime: The child may be active and uncooperative, making treatment less effective and potentially stressful.
3. After the child eats: Treatment immediately after meals may increase risk of vomiting or aspiration.
4. After the parents leave: Young children need parental reassurance during respiratory treatment. Administering nebulizers in the parent’s absence can increase anxiety and worsen symptoms.
Take home points
- Calm, relaxed children respond better to nebulizer treatments.
- Administering during naptime minimizes stress and agitation, improving airway safety and medication effectiveness.
- Always monitor respiratory status during and after the treatment.
- Ensure parental presence and reassurance to reduce anxiety.
Correct Answer is ["A","C","D"]
Explanation
Croupis a common respiratory illness in toddlers characterized by a barking cough, often caused by viral inflammation leading to airway narrowing. Discharge teaching focuses on home management and recognizing signs of worsening illness.
Rationale for correct answers:
1. Cool mist helps soothe inflamed airwaysand can reduce airway irritation, making breathing easier. It is a safe, non-invasive home therapy to help alleviate symptoms.
3. Stridor at restindicates significantairway obstructionand respiratory distress that requires urgent medical evaluation to prevent respiratory failure.
4. Adequate hydration thins mucus secretions, prevents dehydration, and supports overall recovery.
Rationale for incorrect answers:
2. Over-the-counter cough syrups are not recommended for young children due to limited efficacy and potential side effects.
5. Aspirinis contraindicated in children because of the risk of Reye’s syndrome, a serious and potentially fatal condition.
Take home points
- Use cool-mist humidifiers and maintain hydration to support symptom relief in croup.
- Recognize signs of respiratory distress such as stridor at rest and seek emergency care promptly.
- Avoid cough syrups and aspirin in young children.
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