A nurse is caring for a preschooler who has epiglottitis from a streptococcal infection. Which of the following actions should the nurse take?

Attempt to obtain a throat culture.

Use a tongue depressor to observe the back of the throat.

Apply humidified oxygen via a mask.

Initiate airborne precautions.

Answer and Explanation

The Correct Answer is C

A. Attempt to obtain a throat culture: This is contraindicated because manipulating the throat could exacerbate airway obstruction, leading to a potential respiratory emergency.

B. Use a tongue depressor to observe the back of the throat: This can provoke a spasm or cause complete airway obstruction in a child with epiglottitis and should be avoided.

C. Apply humidified oxygen via a mask: This helps to keep the airways moist and can provide some relief and improve oxygenation while minimizing the risk of airway manipulation.

D. Initiate airborne precautions: Epiglottitis primarily requires droplet precautions, not airborne. Airborne precautions are used for diseases like tuberculosis, which are spread through smaller droplets that remain suspended in the air.

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Correct Answer is B

Explanation

A. Gently reinsert the tubes. Tympanostomy tubes should not be reinserted by the parent. Inserting the tubes requires medical expertise and should be performed by a healthcare professional to avoid damaging the ear.

B. Call the health care clinic to report that the tubes have fallen out. This is the correct action. The healthcare provider needs to be informed to assess if new tubes are necessary. Tubes may naturally fall out as part of the healing process, but professional evaluation is essential to determine the next steps.

C. Reassure the mother that the tubes will not fall out. It is incorrect to reassure the parent that the tubes will not fall out. Tubes can fall out naturally as the eardrum heals, and parents should be prepared for this possibility and know the appropriate steps to take.

D. Take the child to an emergency department. This is generally not necessary unless there are signs of complications such as severe pain, infection, or significant hearing loss. Routine follow-up at the clinic is sufficient for a non-emergency situation like a tube falling out.

A. Assist with administering a blood transfusion. B. Withhold opioids to avoid dependence. C. Encourage exercise. D. Initiate a 2 L/day fluid restriction.

Correct Answer is A

Explanation

A. Assist with administering a blood transfusion. Blood transfusions are often necessary in sickle cell crisis to manage severe anemia and improve oxygen delivery to tissues. This action helps alleviate the symptoms of the crisis and prevent complications.

B. Withhold opioids to avoid dependence. Opioids are essential for managing the severe pain associated with sickle cell crises. Concerns about dependence should not prevent adequate pain management in an acute setting.

C. Encourage exercise. During a sickle cell crisis, rest is crucial to reduce oxygen demand and prevent further sickling of red blood cells. Exercise is contraindicated during a crisis.

D. Initiate a 2 L/day fluid restriction. Adequate hydration is critical in managing sickle cell crisis, as it helps prevent further sickling of cells. Fluid restriction is inappropriate and could worsen the condition.

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A nurse is caring for a preschooler who has epiglottitis from a streptococcal infection. Which of the following actions should the nurse take?

Nursing Test Bank

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