Review Epiglottitis

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Epiglottitis

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Question 1:

A nurse is caring for a 4-year-old child suspected of having epiglottitis.
The child presents with a muffled voice and is leaning forward with outstretched arms.
Which statement regarding epiglottitis is accurate?

A. "Epiglottitis is most commonly caused by viral infections.”.. B. "Epiglottitis primarily affects adolescents and adults.”.. C. "The child may adopt a tripod position to maximize airway patency.”.. D. "Epiglottitis typically results in a loud, high-pitched cry.”..

Answer and Explanation

Choice A:

Epiglottitis is most commonly caused by bacterial infections, specifically Haemophilus influenzae type b (Hib) bacteria. This bacterium can cause inflammation and swelling of the epiglottis, leading to airway obstruction. Viral infections are not the primary cause of epiglottitis in children.

Choice B:

Epiglottitis primarily affects children, not adolescents and adults. The peak incidence occurs in children between the ages of 2 and 6 years.

Choice C:

The child adopting a tripod position, leaning forward with outstretched arms, is a classic sign of epiglottitis. This position helps maximize airway patency and ease breathing. It is a protective mechanism that children instinctively assume to maintain their airway.

Choice D:

Epiglottitis does not typically result in a loud, high-pitched cry. The child with epiglottitis is usually quiet and prefers to sit still in a tripod position to maintain airway patency.

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Question 2:

A client is brought to the emergency room with suspected epiglottitis.
The client is drooling saliva and has difficulty swallowing.
Which statement accurately describes the pathophysiology of epiglottitis?

A. "Epiglottitis causes the epiglottis to shrink and recede into the throat.”.. B. "The inflammation in epiglottitis primarily affects the vocal cords.”.. C. "Epiglottitis leads to increased airway resistance and respiratory distress.”.. D. "The swelling in epiglottitis is limited to the vocal cord area.”..

Answer and Explanation

Choice A:

Epiglottitis does not cause the epiglottis to shrink and recede into the throat. Instead, it leads to inflammation and swelling of the epiglottis, causing airway obstruction.

Choice B:

The inflammation in epiglottitis does not primarily affect the vocal cords. It specifically affects the epiglottis, a flap-like structure located at the base of the tongue, which covers the trachea during swallowing to prevent food or liquid from entering the windpipe.

Choice C:

Epiglottitis leads to increased airway resistance and respiratory distress due to the swelling and obstruction of the airway. This can result in difficulty swallowing, drooling, and a muffled voice, as seen in the client's symptoms described in the question.

Choice D:

The swelling in epiglottitis is not limited to the vocal cord area. It involves the epiglottis, which can obstruct the airway and cause respiratory distress.

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Question 3:

(Select all that apply): A nurse is educating parents about risk factors for epiglottitis in children.
Which factors should the nurse include in the discussion?

A. Haemophilus influenzae type b (Hib) infection. B. Trauma to the throat or neck. C. Thermal injury from hot liquids. D. Seasonal factors. E. Mycoplasma pneumoniae infection.

Answer and Explanation

Choice A:

Haemophilus influenzae type b (Hib) infection is a significant risk factor for epiglottitis in children. Hib vaccination has significantly reduced the incidence of epiglottitis caused by this bacterium.

Choice B:

Trauma to the throat or neck is not a common risk factor for epiglottitis. The primary cause is bacterial infection, especially by Hib bacteria.

Choice C:

Thermal injury from hot liquids can lead to thermal epiglottitis, a rare condition caused by the inhalation of hot steam or liquid, resulting in inflammation and swelling of the epiglottis.

Choice D:

Seasonal factors are not a direct risk factor for epiglottitis. The condition is primarily caused by bacterial infections and is not significantly influenced by seasonal changes.

Choice E:

Mycoplasma pneumoniae infection is not a common cause of epiglottitis. Bacterial infections, especially Hib, are the primary culprits in pediatric cases of epiglottitis.

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Question 4:

A nurse is assessing a 6-year-old child with suspected epiglottitis.
The child is leaning forward and has a muffled voice.
Which statement is true regarding the demographics of epiglottitis?

A. "Epiglottitis is more common in females than in males.”.. B. "It primarily affects infants under 1 year old.”.. C. "Epiglottitis is more prevalent in colder months.”.. D. "Children between 2 and 8 years old are at higher risk.”..

Answer and Explanation

Choice A:

Epiglottitis is not necessarily more common in females than in males. It can affect both genders equally.

Choice B:

While epiglottitis is more common in children, it primarily affects those between the ages of 2 and 8 years old, not just infants under 1 year old.

Choice C:

There is no significant evidence to suggest that epiglottitis is more prevalent in colder months. The occurrence of epiglottitis is not strictly related to seasonal changes.

Choice D:

Children between 2 and 8 years old are at higher risk of developing epiglottitis. This age group is more susceptible due to their smaller airways and less developed immune systems, making them prone to infections like epiglottitis.

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Question 5:

A client presents with symptoms of epiglottitis, including difficulty swallowing and a muffled voice.
What is the most common causative agent of epiglottitis in children?

A. Streptococcus pneumoniae. B. Staphylococcus aureus. C. Haemophilus influenzae type b (Hib). D. Neisseria meningitidis.

Answer and Explanation

Choice A:

Streptococcus pneumoniae is a common bacterium associated with respiratory infections, but it is not the most common causative agent of epiglottitis in children.

Choice B:

Staphylococcus aureus can cause various infections, but it is not the primary causative agent of epiglottitis in children.

Choice C:

Haemophilus influenzae type b (Hib) is the most common causative agent of epiglottitis in children. Hib infection can lead to inflammation and swelling of the epiglottis, causing the characteristic symptoms of epiglottitis, including difficulty swallowing and a muffled voice.

Choice D:

Neisseria meningitidis is a bacterium that can cause meningitis and septicemia, but it is not the main causative agent of epiglottitis.

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Question 6:

A nurse is assessing a child with suspected epiglottitis.
Which clinical manifestation should the nurse prioritize when evaluating the severity of the condition?

A. "I can't swallow, and my throat hurts.”.. B. "I feel anxious and restless.”.. C. "I'm making a high-pitched sound when I breathe.”.. D. "My skin and lips look bluish.”..

Answer and Explanation

Choice A:

Difficulty swallowing and throat pain are common symptoms of epiglottitis, but they do not necessarily indicate the severity of the condition.

Choice B:

Feeling anxious and restless may be a sign of distress, but it does not specifically indicate the severity of epiglottitis.

Choice C:

Making a high-pitched sound when breathing (called stridor) is a serious symptom indicating airway obstruction. While this is concerning, it is not the most critical manifestation in evaluating the severity of epiglottitis.

Choice D:

Cyanosis, characterized by a bluish discoloration of the skin and lips, indicates severe lack of oxygen and is a critical sign in assessing the severity of epiglottitis. Cyanosis suggests inadequate oxygenation and is indicative of impending respiratory failure, requiring immediate medical intervention.

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Question 7:

During the nursing assessment of a child with suspected epiglottitis, the nurse observes that the child is drooling and has difficulty managing secretions.
Which statement made by the child would be most concerning for the nurse?

A. "My throat is really sore.”.. B. "I can't stop drooling.”.. C. "I feel restless and agitated.”.. D. "I'm having trouble breathing.”..

Answer and Explanation

Choice A:

The statement "My throat is really sore.”. is a common symptom of throat infections, including epiglottitis. While it is concerning, it is not the most concerning symptom in this case. Epiglottitis can rapidly progress, leading to respiratory distress, which is a life-threatening condition.

Choice B:

The statement "I can't stop drooling.”. is a significant concern in a child suspected of having epiglottitis. Drooling and difficulty managing secretions are hallmark signs of epiglottitis and indicate compromised airway protection. This symptom suggests that the epiglottis is inflamed and obstructing the airway, potentially leading to respiratory distress and the need for urgent intervention.

Choice C:

The statement "I feel restless and agitated.”. is a non-specific symptom and may be seen in various illnesses, including infections. While it indicates the child's discomfort, it does not directly point to the severity of the condition or airway compromise, making it less concerning than the inability to handle secretions.

Choice D:

The statement "I'm having trouble breathing.”. is the most concerning symptom in a child suspected of having epiglottitis. Difficulty breathing indicates significant airway obstruction, which can rapidly progress to respiratory failure. This symptom requires immediate medical attention and intervention to secure the airway and prevent further complications.

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Question 8:

A nurse is assessing a child with suspected epiglottitis.
Select all the clinical manifestations that are characteristic of epiglottitis.

A. Drooling and inability to handle secretions. B. Cough and wheezing. C. Cyanosis and pallor. D. Muffled voice and stridor. E. Tachypnea and tachycardia.

Answer and Explanation

Choice A:

Drooling and inability to handle secretions are characteristic manifestations of epiglottitis. Inflamed epiglottis impairs the child's ability to swallow and manage saliva, leading to drooling. This symptom is a key clinical indicator of epiglottitis.

Choice B:

Cough and wheezing are not typical manifestations of epiglottitis. Epiglottitis primarily affects the upper airway, leading to symptoms such as drooling, stridor, and respiratory distress. Cough and wheezing are more common in lower respiratory tract infections, such as bronchitis or pneumonia.

Choice C:

Cyanosis and pallor are not specific to epiglottitis and can occur in various respiratory and cardiovascular conditions. While these symptoms indicate decreased oxygenation, they are not unique to epiglottitis and are not considered characteristic manifestations of this condition.

Choice D:

Muffled voice and stridor are characteristic signs of epiglottitis. A muffled voice occurs due to the swollen epiglottis obstructing airflow, resulting in a change in the sound of the child's voice. Stridor is a high-pitched, noisy breathing sound that occurs during inspiration and indicates partial airway obstruction. Both symptoms are indicative of compromised upper airway in epiglottitis.

Choice E:

Tachypnea (rapid breathing) and tachycardia (rapid heartbeat) are common physiological responses to respiratory distress. In epiglottitis, the child may exhibit these symptoms due to the body's attempt to compensate for decreased oxygen levels. These manifestations reflect the severity of the condition and the child's physiological response to airway compromise.

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Question 9:

In the diagnostic evaluation of epiglottitis, which imaging test is preferred for visualizing a swollen epiglottis?

A. Computed tomography (CT) scan. B. Magnetic resonance imaging (MRI). C. Lateral neck radiograph. D. X-ray of the chest.

Answer and Explanation

Choice A:

Computed tomography (CT) scan provides detailed images of internal structures but is not the preferred imaging test for visualizing a swollen epiglottis. CT scans are more commonly used for evaluating conditions in other parts of the body, such as the brain or abdomen, and may not provide the necessary detail for assessing the upper airway.

Choice B:

Magnetic resonance imaging (MRI) can produce high-resolution images of soft tissues, but it is not the first choice for visualizing a swollen epiglottis. MRI scans are time-consuming and may not be readily available in urgent situations. In cases of suspected epiglottitis, prompt diagnosis and intervention are crucial to prevent respiratory compromise.

Choice C:

Lateral neck radiograph is the preferred imaging test for visualizing a swollen epiglottis. This X-ray technique allows healthcare providers to assess the size of the epiglottis and its relationship with nearby structures. A classic finding in epiglottitis on a lateral neck radiograph is a swollen epiglottis, giving a thumbprint sign appearance. This imaging study can aid in the diagnosis and guide appropriate management.

Choice D:

X-ray of the chest is not the preferred imaging test for evaluating epiglottitis. While a chest X-ray can provide information about the lungs and surrounding structures, it does not offer the necessary detail to visualize the upper airway, including the epiglottis. Lateral neck radiograph is specifically tailored to assess the structures in the throat region and is the imaging modality of choice in suspected cases of epiglottitis.

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Question 10:

When conducting a nursing assessment of a child with suspected epiglottitis, what information should the nurse include in the history-taking process? .

A. Allergies to foods. B. Immunization history. C. Recent travel destinations. D. Current hobbies and interests.

Answer and Explanation

Choice A:

Allergies to foods are not directly related to epiglottitis. While it's essential information for a general health assessment, it doesn't provide specific insights into the condition.

Choice B:

Immunization history is crucial in the assessment of a child with suspected epiglottitis. Haemophilus influenzae type b (Hib) vaccination is highly effective in preventing epiglottitis caused by Hib bacteria. Knowing the child's immunization status helps the nurse assess the likelihood of Hib infection.

Choice C:

Recent travel destinations are not directly relevant to epiglottitis. This information is more pertinent when assessing the risk of diseases like malaria or dengue fever, which are region-specific.

Choice D:

Current hobbies and interests are not pertinent to the assessment of epiglottitis. This information is important in a broader context for understanding the child's lifestyle but does not provide relevant data regarding the condition.

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Question 11:

A nurse is caring for a child with epiglottitis.
Which nursing intervention should the nurse prioritize to maintain a patent airway?

A. Administering antibiotics intravenously as prescribed. B. Providing humidified air or cool mist therapy to moisten the airway. C. Administering corticosteroids intravenously as prescribed. D. Administering analgesics and antipyretics as prescribed.

Answer and Explanation

Choice A:

Administering antibiotics intravenously is important in treating the infection, but it doesn't directly address maintaining a patent airway. The priority in epiglottitis is to ensure an open airway to prevent respiratory distress.

Choice B:

Providing humidified air or cool mist therapy helps moisten the airway, making it easier for the child to breathe. This intervention can provide immediate relief and aid in maintaining a patent airway, which is crucial in epiglottitis.

Choice C:

Administering corticosteroids intravenously can help reduce inflammation, but it might not be the primary intervention to maintain a patent airway. Humidified air therapy directly addresses airway moisture, which is essential in epiglottitis management.

Choice D:

Administering analgesics and antipyretics can address pain and fever associated with epiglottitis but does not directly contribute to maintaining a patent airway. While these medications can improve the child's comfort, they are not the priority in this situation.

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Question 12:

A nurse is providing education to a child and their family about the prevention of epiglottitis.
What information should the nurse include in the education?

A. The importance of oral medications to relieve symptoms. B. The signs and symptoms of epiglottitis. C. Avoiding complete immunization against Hib. D. Using nebulized medications for treatment.

Answer and Explanation

Choice A:

The importance of oral medications to relieve symptoms is relevant, but it doesn't specifically prevent epiglottitis. Preventive measures like vaccination are more crucial in avoiding the condition.

Choice B:

Educating the child and their family about the signs and symptoms of epiglottitis is essential for early recognition and prompt medical intervention. Understanding the symptoms can lead to quicker medical attention, which is vital in managing epiglottitis effectively.

Choice C:

Avoiding complete immunization against Hib is not a recommended practice. Hib vaccination significantly reduces the risk of epiglottitis caused by Hib bacteria. Encouraging complete immunization is a key preventive measure against the disease.

Choice D:

Using nebulized medications for treatment might be a part of the management plan if the child already has epiglottitis, but it's not a preventive measure. Prevention focuses on vaccination and awareness of symptoms, making choice D less relevant in the context of prevention.

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Question 13:

A nurse is caring for a child with epiglottitis and needs to provide supportive care.
Select all appropriate interventions for supportive care.

A. Administering antibiotics intravenously as prescribed. B. Administering corticosteroids intravenously as prescribed. C. Providing hydration and nutrition by intravenous fluids. D. Educating the child and family about the prevention of epiglottitis. E. Providing humidified air or cool mist therapy to moisten the airway.

Answer and Explanation

Choice A:

Administering antibiotics intravenously as prescribed is a crucial intervention in the management of epiglottitis. Epiglottitis is commonly caused by bacterial infections, and intravenous antibiotics are essential to target the underlying infection and prevent its spread. The choice of antibiotic should be based on the specific causative organism and local antibiotic resistance patterns.

Choice B:

Administering corticosteroids intravenously as prescribed is another important intervention in the supportive care of epiglottitis. Corticosteroids help reduce airway inflammation, which is a significant concern in epiglottitis. By decreasing inflammation, corticosteroids can alleviate respiratory distress and improve the patient's breathing.

Choice C:

Providing hydration and nutrition by intravenous fluids is necessary in the management of epiglottitis, especially if the child is having difficulty swallowing or breathing. Intravenous fluids ensure that the child receives adequate hydration and nutrition while minimizing the risk of aspiration, which can worsen the airway obstruction.

Choice D:

Educating the child and family about the prevention of epiglottitis is important for overall health awareness, but it is not a direct supportive intervention for a child already diagnosed with the condition. While prevention strategies, such as timely vaccinations and good hygiene, are crucial, they do not constitute immediate supportive care for a child with active epiglottitis.

Choice E:

Providing humidified air or cool mist therapy to moisten the airway is a supportive measure that can help ease breathing difficulties in children with epiglottitis. Humidified air or cool mist therapy can soothe the inflamed airway, making it easier for the child to breathe. It is essential to maintain a moist environment to prevent further irritation and discomfort.

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Question 14:

A nurse is managing the airway of a child with epiglottitis.
Which statement about airway management is correct?

A. Tracheostomy is preferred over intubation. B. Intubation may be the only option for all cases. C. Tracheostomy is less invasive than intubation. D. Intubation is always the first choice for airway management.

Answer and Explanation

Choice A:

Tracheostomy may be necessary in severe cases of epiglottitis where the airway obstruction is life-threatening and cannot be managed with other interventions. In such cases, creating a surgical airway via tracheostomy can provide a more stable and secure airway, ensuring adequate oxygenation. However, this option is typically considered when other measures, such as intubation, have failed or are not feasible due to the severity of the obstruction.

Choice B:

Intubation may be required in cases where the airway obstruction is significant, and the child is unable to maintain oxygenation and ventilation adequately. Intubation allows for mechanical ventilation, ensuring a patent airway and adequate oxygen supply. However, it is not always the only option and may depend on the severity of the condition and the response to other interventions.

Choice C:

Tracheostomy is more invasive than intubation. While tracheostomy is a surgical procedure that involves creating an opening in the trachea, intubation involves inserting a tube through the mouth or nose into the trachea. Tracheostomy is considered more invasive because it requires a surgical incision and the placement of a permanent or temporary tracheostomy tube.

Choice D:

Intubation is not always the first choice for airway management in epiglottitis. The choice of airway management (intubation, tracheostomy, or other interventions) depends on the severity of the airway obstruction, the child's clinical condition, and the healthcare provider's assessment. Intubation may be chosen if the obstruction is significant and the child cannot maintain adequate oxygenation and ventilation.

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Question 15:

A nurse is administering corticosteroids to a child with epiglottitis.
What should the nurse monitor for as potential side effects of corticosteroid therapy?

A. Signs of adrenal insufficiency and hyperglycemia. B. Decreased oxygen saturation levels. C. Allergic reactions to the corticosteroids. D. Increased sensitivity to antibiotics.

Answer and Explanation

Choice A:

The nurse should monitor for signs of adrenal insufficiency and hyperglycemia as potential side effects of corticosteroid therapy. Corticosteroids can suppress the adrenal glands, leading to adrenal insufficiency, which can manifest as weakness, fatigue, low blood pressure, and abdominal pain. Hyperglycemia (elevated blood sugar levels) is a common side effect of corticosteroids and can worsen diabetes or predispose non-diabetic individuals to high blood sugar levels.

Choice B:

Decreased oxygen saturation levels are not a common side effect of corticosteroid therapy. Corticosteroids help reduce airway inflammation, which can actually improve oxygenation in conditions like epiglottitis by reducing airway obstruction and respiratory distress.

Choice C:

Allergic reactions to corticosteroids are possible, but they are relatively rare. Symptoms of an allergic reaction can include rash, itching, swelling, severe dizziness, or difficulty breathing. While allergic reactions are a concern with any medication, they are not the primary side effect that nurses should monitor for when administering corticosteroids.

Choice D:

Increased sensitivity to antibiotics is not a known side effect of corticosteroid therapy. Corticosteroids work by suppressing the immune response and reducing inflammation, but they do not affect the body's sensitivity to antibiotics. Antibiotic effectiveness is determined by factors such as the specific antibiotic used, the type of bacteria causing the infection, and antibiotic resistance patterns.

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Epiglottitis

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