A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?

Continuously monitor the child's respiratory status.

Administer pancreatic enzymes with meals.

Assess the child for frequent swallowing.

Carefully suction the child's oropharynx to remove secretions.

Answer and Explanation

The Correct Answer is A

A. Correct. Epiglottitis can cause airway obstruction, so continuous respiratory monitoring is crucial to detect any signs of respiratory distress.

B. Incorrect. Administering pancreatic enzymes is not relevant to epiglottitis.

C. Incorrect. Frequent swallowing assessment is not the priority for epiglottitis. Airway management is.

D. Incorrect. Suctioning may be necessary, but continuous respiratory monitoring takes precedence.

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Correct Answer is A

Explanation

A. Correct. Measuring gastric residual volumes every 4 hours is important to assess gastric emptying and to determine if the client can tolerate the feedings. If residuals are high, it may indicate delayed gastric emptying and the need to adjust the feeding rate.

B. Incorrect. While flushing the NG tube before and after medications is important to maintain patency, it is typically done with sterile water, not sodium chloride, unless otherwise specified by a protocol. Therefore, this statement may not be fully accurate.

C. Incorrect. The head of the bed should be elevated to a 30-45° angle to help prevent aspiration during enteral feedings.

D. Incorrect. The rate of the feeding should be advanced gradually to prevent overloading the client's gastrointestinal tract. This does not involve advancing the rate every 2 hours.

A. Hold the bottle in the center of the sterile field when pouring the solution. B. Place sterile gauze over areas of spilled solution within the sterile field. C. Hold the irrigation solution bottle with the label facing away from the palm of the hand. D. Remove the cap and place it sterile-side up on a clean surface.

Correct Answer is D

Explanation

As explained, holding the bottle directly over the sterile field can result in contamination. It's crucial to pour the solution from above or to the side of the sterile field, making sure the bottle doesn't touch the field or anything in the field. This minimizes the risk of contaminating the sterile setup.

If solution is spilled on the sterile field, that area is contaminated, and you cannot make it sterile again by covering it with gauze. The correct approach would be to discard the contaminated items and set up a new sterile field.

While it's important not to touch the label side of the bottle, this option doesn't address the action of placing the cap. The most important part of pouring a sterile solution is ensuring the cap stays sterile, which is what option D addresses.

When performing a sterile procedure, after removing the cap from a sterile bottle, the cap should be placed sterile-side up on a clean surface or a sterile field. This is because the sterile side of the cap should not touch any non-sterile surfaces, and placing it sterile-side up ensures it stays sterile.

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A nurse is planning care for a toddler who has epiglottitis. Which of the following interventions should the nurse include?

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