A nurse is caring for a child with croup in the hospital.
The child is receiving humidified air and nebulized racemic epinephrine.
The nurse monitors the child's respiratory status closely.
Which of the following findings would indicate to the nurse that the child's condition is worsening?

Choice A rationale:

Continuing to monitor the child's respiratory status may not be the best action in this situation, as the child's respiratory status is worsening and they are becoming increasingly agitated.

Immediate intervention is required to alleviate the child's distress.

Choice B rationale:

Administering oxygen therapy as needed is a supportive measure in respiratory distress situations, but in the case of severe croup with worsening respiratory status and agitation, nebulized epinephrine is the treatment of choice to reduce airway inflammation and improve breathing.

Choice C rationale:

Nebulized epinephrine is the primary treatment for severe croup as it helps reduce upper airway edema, relieve stridor, and improve respiratory distress.

It acts by causing vasoconstriction, which reduces swelling in the upper airway, making breathing easier for the child.

Therefore, preparing to administer nebulized epinephrine is the most appropriate action in this situation.

Choice D rationale:

Notifying the physician immediately is essential, but immediate intervention to improve the child's respiratory distress is also necessary.

Nebulized epinephrine should be administered promptly to alleviate the child's symptoms and prevent further deterioration.

Choice A rationale:

An oxygen saturation level of 95% is within the normal range (normal range is typically 95-100%).

While it is essential to monitor oxygen saturation, this value does not indicate worsening of the child's condition.

Choice B rationale:

A respiratory rate of 30 breaths per minute is above the normal range for a child and can indicate respiratory distress.

An increased respiratory rate is a concerning sign, suggesting the child is having difficulty breathing.

This finding indicates the child's condition is worsening and requires prompt attention.

Choice C rationale:

Mild retractions suggest that the child is working harder to breathe but may not necessarily indicate a severe worsening of the condition.

Retractions are a sign of increased respiratory effort but may vary in severity.

Choice D rationale:

A child with croup experiencing severe respiratory distress may not be able to speak in complete sentences due to the difficulty in breathing.

However, the ability to speak in complete sentences alone may not be a definitive indicator of worsening.

Monitoring the respiratory rate and effort is crucial in assessing the child's condition accurately.