Which is diagnostic for epiglottitis?

Blood test.

Throat swab.

Lateral neck x-ray of the soft tissue.

Signs and symptoms.

Answer and Explanation

The Correct Answer is C

Epiglottitis is a life-threatening bacterial infection (commonly caused by Haemophilus influenzae type B) that leads to inflammation and swelling of the epiglottis, potentially causing complete airway obstruction. It most often affects children aged 2–6 years and presents with sudden onset of high fever, drooling, dysphagia, muffled voice, and tripod positioning.

Rationale for correct answer:

3. A lateral neck x-ray can confirm the diagnosis by revealing the classic “thumbprint sign”, which represents an enlarged, swollen epiglottis protruding into the airway. This imaging study helps differentiate epiglottitis from croup, which shows a “steeple sign” (subglottic narrowing). Importantly, the x-ray should only be performed after the airway is stabilized and under controlled conditions with emergency equipment and personnel available.

Rationale for incorrect answers:

1. Blood test such as CBC or cultures may show infection but are nonspecific and not diagnostic. They are typically performed after the airway is secure.

2. Swabbing or inspecting the throat are contraindicated since it can trigger laryngospasm and complete airway obstruction due to tissue irritation.

4. Although signs and symptoms such as drooling, tripod position, muffled voice, or stridor are strongly suggestive, a definitive diagnosis requires visualization or imaging. They should be safely done through a lateral neck x-ray or direct laryngoscopy in a controlled setting.

Take home points

Lateral neck x-ray showing the “thumbprint sign” confirms epiglottitis.
Never use a tongue blade or obtain a throat swab since both can precipitate complete obstruction.
Ensure emergency airway equipment is available before any diagnostic procedure.
Immediate I.V. antibiotics and airway management are key to treatment.

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Correct Answer is D

Explanation

Epiglottitisis a life-threatening bacterial infection(commonly caused by Haemophilus influenzae type B) that causes rapid inflammation and swelling of the epiglottis, leading to airway obstruction. The illness progresses suddenly and severely, often within hours, and requires immediate airway management and IV antibiotic therapy.

Rationale for correct answer:

4. “Epiglottitis is rapidly progressive; you could not have predicted his symptoms would worsen so quickly.”This response provides emotional support and reassurance to the parent. It helps alleviate guilt by explaining that the condition worsens very rapidly, often within hours, and that early recognition is difficult. The nurse is showing empathy, validating the parent’s feelings while maintaining focus on the child’s urgent care needs.

Rationale for incorrect answers:

1. “Children this age rarely get epiglottitis; you should not blame yourself.”While reassuring, this statement is inaccurate. Epiglottitis most commonly affects children ages 2 to 6 years. It also minimizes the parent’s emotions rather than addressing them therapeutically.

2. “It is always better to have your child evaluated at the first sign of illness rather than wait until symptoms worsen.”This is non-therapeutic and blaming, implying that the parent’s delay contributed to the severity of the illness. It increases guilt instead of offering comfort.

3. “Epiglottitis is slowly progressive, so early intervention may have decreased the extent of your son’s symptoms.”This is factually incorrect since epiglottitis progresses rapidly, not slowly. Such misinformation may increase the parent’s distress.

Take home points

Epiglottitis is a medical emergency that can progress from mild sore throat to severe airway obstruction within hours.
The nurse’s role includes both clinical vigilance and emotional support for the family.
Therapeutic communication focuses on reassurance, empathy, and education without assigning blame.
Early recognition and prompt airway management are critical for survival.

A. Progressive barking cough B. Increasing irritability C. Increasing heart rate D. Productive cough

Correct Answer is C

Explanation

Acute epiglottitisis a life-threatening bacterial infection(commonly due to Haemophilus influenzae type B) that causes inflammation and swelling of the epiglottis, leading to rapid airway obstruction. It primarily affects children aged 2–6 years and presents with sudden onset of high fever, drooling, dysphagia, muffled voice, and inspiratory stridor.

Rationale for correct answer:

3. Increasing heart rateis an early and sensitive indicator of worsening hypoxia and respiratory distressin children. As oxygen levels drop, the heart rate rises in an attempt to maintain oxygen delivery to vital organs. If untreated, tachycardia may later progress to bradycardia and cardiac arrest, a late and ominous sign of severe hypoxia.

Rationale for incorrect answers:

1. A barking (seal-like) coughis characteristic of croup (laryngotracheobronchitis), not epiglottitis. Children with epiglottitis typically have no coughor a muffled voicedue to painful swallowing and airway swelling.

2. While irritabilitymay occur as a response to hypoxia, it is a nonspecific early sign. The increase in heart rate provides a more objective and direct indicator of escalating respiratory distress.

4. Coughingis usually absent in epiglottitis because of pain and airway obstruction. Productive coughs are more typical in lower respiratory infections, such as pneumonia or bronchitis.

Take home points

Tachycardia and restlessness are early signs of hypoxia; bradycardia and cyanosis are late, preterminal signs.
In epiglottitis, airway obstruction can progress rapidly hence continuous monitoring of respiratory rate, heart rate, and oxygen saturation is essential.
Avoid procedures that agitate the child; maintain airway equipment and intubation readiness at the bedside.
Early recognition and I.V. antibiotic therapy after securing the airway are key to recovery.

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Which is diagnostic for epiglottitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. Which is the nurse’s best response to this parent whose child is diagnosed with epiglottitis and is in severe distress and in need of intubation?

Correct Answer is D

Explanation

Which sign in a 3-year-old child with acute epiglottitis indicates that the client’s respiratory distress is increasing?

Correct Answer is C

Explanation

Which nursing concern should be a priority for the nurse when working with the family of a toddler being treated for acute laryngotracheobronchitis?

A 4-year-old female child presents to the emergency department with a sore throat, difficulty swallowing, and a suspected diagnosis of acute epiglottitis. Which information should be included in the initial assessment of the child? Select all that apply

Which is diagnostic for epiglottitis?

While examining a child with acute epiglottitis, a nurse should have which item available?

The parent of a child with croup tells the nurse that her other child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse’ s best response?

What should be the nurse’s first action with a child who has a high fever, dysphagia, drooling, tachycardia, and tachypnea?

A 2-year-old child is brought to the emergency department in respiratory distress. The child is drooling, sitting upright and leaning forward with chin thrust out, mouth open, and tongue protruding. Which nursing intervention is most appropriate?

During the recovery stages of croup, a nurse should explain which intervention to parents?