Pediatric Nursing Demystified

the airway. The typical patient with LTB is a toddler who develops the classic

“barking” cough and acute stridor after several days of coryza.

Signs and Symptoms

Brassy cough.

Gradual onset of low-grade fever.

The child struggles to inhale air past the obstruction and into the lungs

producing an inspiratory stridor.

The child may be in moderate respiratory distress with mild wheezing.

Symptoms of hypoxia and airway obstruction may lead to respiratory

acidosis and respiratory failure.

Test Results

These organisms are responsible for LTB:

Parainfluenza virus types 1, 2, and 3

RSV

Influenza A and B

Mycoplasma pneumoniae

Treatment

The major objective for treatment is medical management of the infectious

process and maintaining an airway for adequate respiratory exchange. Children

with mild croup without stridor are managed at home. High humidity with

cool mist provides relief in most cases. Fluids are essentials for recovery.

If the child is unable to take fluids, intravenous fluid therapy is initiated.

Nursing Interventions

Vigilant observation and accurate of assessment of the respiratory status.

Noninvasive cardiac, respiratory, and blood gas monitoring.

Ensure intubation equipment is immediately accessible to the patient.

Keep the child comfortable.

Allow the parent or caregiver to lie next to the child in the mist tent to

lessen anxiety.

Modify treatment to cool moist mist blowing directly toward the patient

from the hose when child will not tolerate mist tent.

Acute Epiglottitis

What Went Wrong?

Acuteepiglottitisis a serious obstructive inflammatory process resulting from

a bacterial infection that occurs principally in children between 2 and 5 years of

age but can occur from infancy to adulthood. The obstruction is supraglottic as

opposed to subglottic as in laryngitis. This disorder requires immediate attention.

1

5

4

3

2

CHAPTER 5/ Respiratory Conditions^77