A 3-year-old child was brought into the emergency room this morning with a sudden onset of "fast and noisy breathing". According to his parents, he had sneezing and a runny nose last week but seemed to have recovered. The child lives with 2 older, school-age siblings, his parents, and 3 dogs. He was born at 37 weeks' gestation. The parents deny smoking, but his grandmother cares for him in the afternoons and smokes outside when she is at the house.

He has no significant medical history. He has received all vaccines except for those due at 3 years. Upon exam, the child is found to have inspiratory stridor and retractions. Will admit to the pediatric floor for treatment

The nurse collects items to replace the peripheral Intravenous line.

Which 2 items must the nurse make sure is available before attempting to place the intravenous line?

C. Manual resuscitation bag: In the case of a child with inspiratory stridor and retractions, there is a concern about airway obstruction. Having a manual resuscitation bag available is crucial to ensure that the child's airway can be effectively managed in case of respiratory distress.

E. An advanced airway kit: If the child's condition worsens and he experiences severe respiratory distress or failure, an advanced airway may be necessary to secure the airway and provide proper oxygenation. Having an advanced airway kit available is important in case intubation becomes necessary.

Incorrect answers:

A. Elbow restraints: Elbow restraints are not typically used during peripheral intravenous line placement. They are used to prevent children from bending their arms excessively after specific surgeries or procedures.

B. The child's favorite toy: While having a favorite toy might help distract the child and reduce anxiety, it is not a critical item needed for the placement of a peripheral intravenous line.

D. A dose of subcutaneous epinephrine: Subcutaneous epinephrine is not used for the placement of an intravenous line. It is typically used to treat severe allergic reactions (anaphylaxis).

F. Nebulized albuterol: Nebulized albuterol is a medication used to treat bronchospasm in conditions such as asthma. While the child is experiencing respiratory distress, the priority is to secure the airway and provide oxygenation, which may involve using a manual resuscitation bag and an advanced airway kit.