A nurse is admitting a child who has acute epiglottitis. Which of the following actions should the nurse take?
Obtain a throat culture.
Initiate droplet isolation precautions.
Assist the child into a supine position.
Check oxygen saturation every 4 hr.
The Correct Answer is B
The nurse should initiate droplet isolation precautions when admitting a child who has acute epiglottitis.
Epiglottitis is commonly caused by Haemophilus influenzae type B and can be transmitted through respiratory droplets.
Choice A is wrong because obtaining a throat culture is not recommended when epiglottitis is suspected, as it can cause further obstruction of the airway.
Choice C is wrong because assisting the child into a supine position can worsen the airway obstruction.
Children with epiglottitis prefer to sit upright with the chin extended and mouth open.
Choice D is wrong because checking oxygen saturation every 4 hours may not be frequent enough for a child with acute epiglottitis who may require continuous monitoring of oxygen saturation.
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Related Questions
Correct Answer is C
Explanation
A weight loss of 7% indicates that the infant is moderately dehydrated.
Dehydration is classified as mild (3-5% weight loss), moderate (6-10% weight loss), or severe (>10% weight loss)1.
Choice A is wrong because a respiratory rate of 28/min is within the normal range for an infant.
Choice B is wrong because a capillary refill time of 1 second is within the normal range.
Choice D is wrong because bradycardia (a slow heart rate) is not a typical sign of moderate dehydration in infants.
Correct Answer is A
Explanation
According to the normal pediatric vital signs chart provided by Cleveland Clinic, the normal blood pressure range for a 2-year-old child should be between 90- 105/55-70 mm Hg. The blood pressure of 118/74 mm Hg is higher than the normal range for a 2- year-old child and should be reported to the provider.
Choice B is wrong because a respiratory rate of 26/min falls within the normal range of 20-30 breaths per minute for a child between ages 1 and.
Choice C is wrong because a pulse rate of 98/min falls within the normal range of 80-125 beats per minute for a child between ages 1 and.
Choice D is wrong because a temperature of 37.2° C (99° F) falls within the normal range for children which is around 98.6 degrees.
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