The nurse in the emergency department is caring for a child who appears extremely ill with a high fever, unable to control their oral secretions. with voice hoarseness and inspiratory stridor and inspiratory sternal retractions while breathing. The nurse suspects epiglottitis. Which would the nurse do next?
Contact the assigned emergency room physician to evaluate the need for an advanced airway
Administer intravenous corticosteroids
Obtain a throat culture
inspect the throat to obtain further data to support the diagnosis
The Correct Answer is A
A. Contact the assigned emergency room physician to evaluate the need for an advanced airway
Explanation:
Epiglottitis is a medical emergency that can rapidly progress to airway obstruction. The classic signs and symptoms include a high fever, difficulty swallowing, voice hoarseness, inspiratory stridor, and sternal retractions. Immediate intervention may be necessary to secure the airway. Therefore, contacting the emergency room physician to evaluate the need for an advanced airway (such as intubation) is a priority.
B. Administer intravenous corticosteroids
Explanation: While corticosteroids may be used in the management of epiglottitis to reduce airway inflammation, securing the airway is the priority in the acute phase. Corticosteroids would typically be administered after securing the airway.
C. Obtain a throat culture
Explanation: Obtaining a throat culture is not the immediate priority in the case of suspected epiglottitis. Prompt intervention to secure the airway takes precedence over diagnostic tests.
D. Inspect the throat to obtain further data to support the diagnosis
Explanation: Direct visualization of the throat (inspection) may exacerbate the airway obstruction and is not recommended in the acute management of suspected epiglottitis. The priority is to secure the airway while minimizing agitation and discomfort for the child. Diagnostic procedures, such as obtaining a throat culture, can be considered after the airway is stabilized.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Has your child been exposed to anyone with chicken pox?"
While chickenpox is caused by a different virus (varicella-zoster virus) and is not directly linked to rheumatic fever, the nurse might inquire about exposure to contagious illnesses as a general part of the assessment.
B. "Has any family member had a sore throat within the past few weeks?"
This question is relevant because rheumatic fever often follows an untreated or inadequately treated group A streptococcal infection, such as strep throat. A sore throat in a family member could indicate the presence of streptococcal infection, which is a crucial factor in the development of rheumatic fever.
C. "Has any family member had a gastrointestinal disorder in the past few weeks?"
Gastrointestinal disorders are not directly associated with the development of rheumatic fever. However, a comprehensive medical history might include questions about recent illnesses to understand the overall health context.
D. "Has your child had difficulty urinating?"
Difficulty urinating is not a typical symptom or risk factor associated with rheumatic fever. This symptom would likely prompt investigation into other potential issues but is not specifically related to rheumatic fever.
Correct Answer is B
Explanation
A. Rye toast
Explanation: Rye contains gluten, so it is not suitable for individuals with celiac disease. It should be avoided in a gluten-free diet.
B. Rice
Explanation:
Celiac disease is a condition characterized by an immune reaction to gluten, a protein found in wheat, barley, and rye. Individuals with celiac disease must follow a gluten-free diet to manage the condition. Rice is a gluten-free grain and is safe for individuals with celiac disease to include in their diet.
C. Wheat bread
Explanation: Wheat contains gluten, and products made from wheat, such as wheat bread, should be avoided in a gluten-free diet for individuals with celiac disease.
D. Oatmeal
Explanation: Oats themselves are gluten-free, but cross-contamination can occur during processing. Some individuals with celiac disease can tolerate pure, uncontaminated oats, but it's essential to ensure that the oats are labeled gluten-free. Regular oats may be cross-contaminated with gluten-containing grains during processing.
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