NCLEX-RN Exam Practice

Category - Respiratory

You are caring for a child with epiglottitis. On assessment of the child what would indicate to you that the child is experiencing airway obstruction?
  1. The child is leaning backwards and supporting himself with his hands and arms.
  2. The child has a low-grade fever and complains of a sore throat.
  3. The child is leaning forward with the chin thrust out.
  4. The child exhibits nasal flaring and bradycardia.
Explanation
Answer: C - If a child is leaning forward with the chin thrust out, this is an indication that the airway may be obstructed. Other indications might include nasal flaring, tachycardia, high fever, and sore throat. To prevent spasms of the epiglottitis and airway obstruction, no attempt should be made to visualize the pharynx.

Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis swells, blocking the flow of air into the lungs.  The epiglottis is a small cartilage "lid" that covers the windpipe.

A number of factors can cause the epiglottis to swell.  

Some examples include:

burns from hot liquids,
injury to your throat
various infections. Historically, the most frequent cause of infection-causing epiglottitis was Haemophilus influenzae type b (Hib).  

This is the same bacterium that causes pneumonia, meningitis, and infections in the bloodstream. Epiglottitis can occur at any age.  Routine Hib vaccination for infants has made epiglottitis rarer than it was in the past.

References: Mayo Clinic
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