Which nursing intervention should the nurse prepare for a child with stridor?

Correct Answer: B

Rationale: In pediatric respiratory assessment, identifying stridor is crucial as it indicates upper airway obstruction. The correct nursing intervention for a child with stridor is option B) Respiratory treatment with racemic epinephrine. Rationale: Racemic epinephrine is a vasoconstrictor that helps reduce upper airway edema quickly, improving the child's breathing. It is a common treatment for croup, a common cause of stridor in children. Why other options are incorrect: A) Immediate IV placement: While IV access may be needed in some cases, it is not the priority in a child with stridor due to airway compromise. C) Setting up a tracheostomy set at the bedside: Tracheostomy is a last resort for severe airway obstruction, not the initial intervention for stridor. D) Informing the child’s parents about a tonsillectomy: Tonsillectomy is not indicated as an immediate intervention for stridor and may not address the acute airway obstruction. Educational context: Educating nurses on pediatric respiratory emergencies is vital to ensure timely and appropriate interventions. Understanding the pathophysiology of conditions like croup and the use of racemic epinephrine can help nurses provide efficient care to children with stridor, optimizing outcomes and reducing complications.

Correct Answer: B

Rationale: In pediatric respiratory assessment, preventing ear infections in children is crucial. The correct answer is B) Your child should be kept away from tobacco smoke. This is because exposure to tobacco smoke can irritate the Eustachian tube, leading to inflammation and increased risk of ear infections. Option A) Your child should be put on a daily dose of Singulair (montelukast) is incorrect because Singulair is primarily used for managing asthma and allergic rhinitis, not for preventing ear infections. Option C) Your child should be kept away from other children with otitis media is not entirely practical as it may not always be possible to avoid contact with other children who may have ear infections. Option D) Your child should always wear a hat when outside is unrelated to preventing ear infections and does not address the main risk factors for developing ear infections. Educationally, it is important to emphasize the impact of environmental factors like tobacco smoke on children's respiratory health. Educating parents on the dangers of secondhand smoke and encouraging a smoke-free environment can significantly reduce the incidence of ear infections and other respiratory issues in children. It is essential for healthcare providers to provide evidence-based recommendations to promote the overall well-being of children.

Correct Answer: C

Rationale: In this scenario, the correct breathing exercise for an asthmatic 3-year-old to increase her expiratory phase is option C) Blow a pinwheel. This exercise promotes prolonged exhalation which can help in the management of asthma symptoms by preventing air trapping in the lungs. Using an incentive spirometer (option A) is more suitable for adults or older children as it requires a certain level of understanding and cooperation which may be challenging for a 3-year-old. Breathing into a paper bag (option B) can potentially be dangerous for a child with asthma as it can lead to a build-up of carbon dioxide in the body. Taking several deep breaths (option D) may not specifically target the expiratory phase and may not be as effective as the pinwheel exercise for this purpose. Educationally, it is important to understand the rationale behind choosing appropriate breathing exercises for children with respiratory conditions to ensure their safety and maximize the effectiveness of the intervention. By selecting the right exercise, healthcare providers can help children improve their lung function and manage their respiratory symptoms more effectively.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Your child will complete a course of intravenous antibiotics. Epiglottitis is a serious condition characterized by inflammation of the epiglottis, which can lead to airway obstruction and respiratory distress. Prompt administration of intravenous antibiotics is crucial to treat the bacterial infection causing epiglottitis and prevent complications. Option B) Your child will undergo surgery to remove the tonsils is incorrect because epiglottitis is not treated by removing the tonsils. Tonsillectomy is a surgical procedure done for recurrent tonsillitis or obstructive sleep apnea, not for epiglottitis. Option C) Your child will receive 10 days of aerosolized ribavirin is incorrect because ribavirin is an antiviral medication used for certain respiratory infections like respiratory syncytial virus (RSV), not for bacterial infections like epiglottitis. Option D) No intervention is necessary is incorrect and dangerous as epiglottitis is a medical emergency requiring immediate intervention to secure the airway and provide appropriate treatment. In an educational context, it is essential for healthcare providers to recognize the signs and symptoms of epiglottitis in children and understand the appropriate management, which includes antibiotics, airway management, and supportive care to ensure positive outcomes and prevent respiratory compromise.

Correct Answer: A

Rationale: The correct answer is A) I should make sure that both my children receive Synagis (palivizumab) injections for the remainder of this year. This statement indicates a lack of understanding of RSV prevention measures. Synagis is not a preventive measure for healthy siblings; it is specifically for high-risk infants. Option B is a correct preventive measure to prevent the spread of RSV within the household. Isolating the infected child can help prevent transmission to other siblings. Option C is a good preventive measure as hand hygiene is crucial in preventing the spread of infections, including RSV. However, it is not the most critical in this scenario. Option D is also a valid preventive measure. Restricting contact with individuals who have respiratory illnesses can help reduce the risk of transmitting RSV to other children. In an educational context, it is important to teach parents accurate and evidence-based preventive measures for RSV. Understanding the appropriate use of medications like Synagis and implementing effective infection control practices can significantly reduce the spread of respiratory illnesses among children. Parents should be empowered with the knowledge to make informed decisions about their children's health and well-being.