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 ["A","B","E"]
Explanation
A."The manifestations are lessened by taking the prednisone every other day instead of daily."
Explanation: Cushingoid characteristics can be related to prolonged corticosteroid use. Adjusting the dosing schedule, such as administering prednisone every other day instead of daily, may help minimize these manifestations.
B."You need to be sure to talk to the doctor about the Cushingoid characteristics."
Explanation: Open communication with the healthcare provider is crucial. Discussing the concerns about Cushingoid characteristics with the doctor allows for appropriate evaluation and potential adjustments to the treatment plan.
C."Which manifestations of this condition do you find most troublesome?"
Explanation: This question opens the discussion to identify specific concerns and allows the nurse to address them individually.
D."I am sure it will be all right; they hardly look unusual."
Explanation: This statement may downplay the parents' concerns. It's essential to acknowledge their worries and provide accurate information about the potential impact of corticosteroids and the plan for managing Cushingoid characteristics.
E."The Cushingoid appearance will gradually disappear once the corticosteroids are tapered and discontinued."
Explanation: Cushingoid characteristics are associated with the side effects of corticosteroid use. The nurse should provide reassurance that, in many cases, these characteristics can gradually improve once the corticosteroid dose is tapered and eventually discontinued.
Correct Answer is D
Explanation
A. Administer 0.9% sodium chloride IV solution: Although IV fluids might be necessary to maintain hydration and circulation, this is not the priority over preventing the spread of infection.
B. Assist with obtaining an x-ray of the child's neck.Imaging can help confirm the diagnosis but should be done after ensuring infection control measures.
C. Initiate IV antibiotics.Antibiotics are crucial for treatment but should follow the implementation of droplet precautions to prevent the spread of infection.
D. Place the child on droplet precautions.
Epiglottitis is a medical emergency primarily caused by bacterial infections, such as Haemophilus influenzae type B (Hib). The first priority is to ensure the safety of both the patient and others by preventing the spread of infection.Placing the child on droplet precautions helps to contain the bacteria and protect healthcare workers and other patients.
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