Which of these factors contributes to infants’ and children's increased risk for upper airway obstruction as compared with adults?
Underdeveloped cricoid cartilage and narrow nasal passages.
Small tonsils and narrow nasal passages.
Cylinder-shaped larynx and underdeveloped sinuses.
Underdeveloped cricoid cartilage and smaller tongue.
The Correct Answer is A
Infants and young children have anatomical and physiological differences in their upper airways compared to adults that increase their risk for airway obstruction. These differences include a smaller and more flexible airway structure and narrower passages, which make them more vulnerable to swelling and obstruction.
Rationale for correct answer:
1. Underdeveloped cricoid cartilage and narrow nasal passages contribute significantly to the increased risk of upper airway obstruction in infants and children. The cricoid cartilage is the narrowest part of a child’s airway and is less rigid than in adults, making it more prone to collapse or swelling. Narrow nasal passages can become easily blocked by secretions or inflammation, further compromising airflow.
Rationale for incorrect answers:
2. Tonsils in children tend to be relatively large, not small, and can contribute to obstruction. The nasal passages are narrow, but this option misses the critical role of cricoid cartilage development.
3. The child’s larynx is funnel-shaped, not cylindrical, with the narrowest point at the cricoid cartilage. While sinuses develop over time, their underdevelopment doesn’t directly increase risk of upper airway obstruction.
4. Children actually have proportionally larger tongues relative to their oral cavity, which can contribute to obstruction, so “smaller tongue” is inaccurate.
Take home points
- Infants and children have a funnel-shaped, narrower airway with a less rigid cricoid cartilage, making them more susceptible to airway obstruction.
- Narrow nasal passages add to the risk by limiting airflow, especially during inflammation.
- Understanding these anatomical differences is critical when assessing respiratory distress in pediatric patients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Croup(laryngotracheobronchitis)is a viral respiratory infection, most often caused by the parainfluenza virus. It is highly contagiousand spreads through respiratory dropletsand direct contactwith contaminated surfaces.
Rationale for correct answer:
1. Hand hygieneis the most effective infection-control measure for preventing the spread of viral respiratory illnesses such as croup. Viruses are easily transmitted through touching contaminated hands, toys, or surfaces, and frequent hand washing with soap and water minimizes transmission. Hand hygiene should be performed before and after contact with the child or their environment.
Rationale for incorrect answers:
2. Isolationis not routinely required for croup unless another specific infection (like RSV or influenza) is suspected or confirmed. Standard precautionswith hand hygiene and droplet precautions if coughing/sneezing are usually sufficient.
3. Whileteaching children to use tissues ishelpful for older children, an 18-month-old or young child may not effectively use tissues or practice good respiratory hygiene. Teaching tissues alone is not adequate to prevent transmission.
4. Keeping siblings in the same room increases the risk of cross-infection, as croup is contagious. Siblings, especially those who are young or immunocompromised, should be kept apart during the illness.
Take home points
- Hand washing is the single most effective way to prevent the spread of respiratory infections like croup.
- Standard precautions should be followed by avoiding close contact, cleaning toys/surfaces, and encouraging covering the mouth when coughing.
- Droplet precautions may be added in healthcare settings if the child is coughing or sneezing.
- Good hygiene practices protect both family members and healthcare providers from infection.
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.
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