Which is the nurse’s best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be?

Complete a course of intravenous antibiotics.

Surgery to remove the tonsils.

10 days of aerosolized ribavirin.

No intervention.

Answer and Explanation

The Correct Answer is A

Epiglottitis is a bacterial infection causing inflammation and swelling of the epiglottis, leading to airway obstruction. It is most commonly caused by Haemophilus influenzae type B (Hib), though Streptococcus and Staphylococcus species can also be responsible. This is a medical emergency that requires immediate airway management and antibiotic therapy to eliminate infection and prevent recurrence.

Rationale for correct answer:

1. Once the airway is secured, treatment includes IV broad-spectrum antibiotics such as ceftriaxone or cefotaxime, followed by oral antibiotics to complete a 7–10-day course. Antibiotics are essential to eradicate the infection, reduce inflammation, and prevent complications like sepsis or meningitis. Supportive care includes oxygen, IV fluids, and close airway monitoring in an intensive care setting.

Rationale for incorrect answers:

2. Tonsillectomy is not indicated for epiglottitis. The tonsils are not involved in this infection, and surgery could worsen airway swelling or obstruction.

3. Ribavirin is an antiviral medication used for respiratory syncytial virus (RSV), not for bacterial infections like epiglottitis.

4. Epiglottitis requires urgent intervention. Without prompt treatment, airway obstruction and death can occur rapidly. Observation alone is unsafe and inappropriate.

Take home points

Immediate airway management is the top priority in epiglottitis.
IV antibiotics such as ceftriaxone and cefotaxime are the mainstay of treatment.
Never perform throat examination or delay antibiotics for diagnostic testing.
Hib vaccination is the key preventive measure.

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Correct Answer is B

Explanation

Acute epiglottitisis a medical emergencymost often caused by Haemophilus influenzae type B (Hib). It results in rapid swelling of the epiglottis, leading to airway obstruction. Typical presentation includes sudden onset of high fever, drooling, severe sore throat, dysphagia, muffled voice, stridor, tripod positioning, absence of cough, anxiety and restlessness due to respiratory distress.

Rationale for correct answer:

2. The child is in the tripod position and has diminished breath sounds and a muffled cough: This finding indicates severe airway obstruction and impending respiratory failure. Tripod position and muffled cough are hallmark signs of epiglottitis. Diminished breath soundssignal that air movement is critically reduced, a life-threatening emergency requiring immediate airway management and preparation for intubation. The child should not be examined or agitated; emergency airway equipment should be ready, and the provider notified immediately.

Rationale for incorrect answers:

1. The child is lying down and has moderate retractions, low-grade fever, and nasal congestion: This is consistent with nasopharyngitis (common cold) or mild upper respiratory infection, not an emergency. The airway is patent.

3. The child is sitting up and has coarse breath sounds, coughing, and fussiness: These findings are more consistent with bronchiolitis or viral croup, which cause airway inflammation but typically have a characteristic cough and coarse sounds, not a muffled voice or tripod positioning.

4. The child is restless and crying, has bilateral wheezes, and is feeding poorly: This presentation suggests asthma or reactive airway disease, not epiglottitis. While concerning, wheezing indicates air is still moving, unlike the silent chest seen in impending obstruction from epiglottitis.

Take home points

Tripod position, muffled voice, and diminished breath sounds signify airway emergency.
Do not attempt throat inspection or use a tongue blade since this can trigger complete obstruction.
Keep emergency intubation and tracheostomy equipment ready at the bedside.
Calm the child, avoid unnecessary interventions, and notify the provider immediately.

A. Potential for impaired family coping B. Impaired growth and development delays related to acute onset of illness C. Impaired social isolation related to confinement in hospital D. Fear or anxiety related to dyspnea and noisy breathing

Correct Answer is D

Explanation

Acute laryngotracheobronchitis (croup)is a viral upper airway infectioncausing inflammation of the larynx, trachea, and bronchi. It typically affects toddlers (6 months–3 years) and presents with barking cough, stridor, respiratory distress, and agitation or anxiety due to difficulty breathing

Rationale for correct answer:

4. Fear or anxiety related to dyspnea and noisy breathing: The child’s labored, noisy breathing is distressing for both the child and the family. Anxiety can aggravate airway obstruction because crying increases airway resistance in a partially obstructed upper airway. Addressing emotional needs and providing reassurance is essential alongside airway management.

Rationale for incorrect answers:

1. Potential for impaired family coping: While family coping may be affected, it is secondary to the immediate concern of child’s respiratory distress.

2. Impaired growth and development delays related to acute onset of illness: Acute croup is short-term, and mild illness does not significantly impact growth or development.

3. Impaired social isolation related to confinement in hospital: Hospitalization may temporarily affect socialization, but it is not a priority concern compared with airway compromise and family anxiety.

Take home points

Airway distress and fear are closely linked in toddlers with croup; managing emotional and physical needs simultaneously is critical.
Nursing interventions include:
- Calm reassurance to the child and parents
- Upright positioning to ease breathing
- Minimizing agitation (avoid invasive procedures unless necessary)

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Which is the nurse’s best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be?

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Naxlex Comprehensive Predictor Exams

Which assessment is of greatest concern in a 15-month-old?

Correct Answer is B

Explanation

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

Correct Answer is D

Explanation

Which instruction should a nurse give the parents of a 2-year-old child who wakes in the night with a barking cough?

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

Which is the nurse’s best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be?

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

Which child is in the greatest need of emergency medical treatment?

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?