Pediatric Nursing Demystified

Signs and Symptoms

Onset is abrupt without cough.

Can rapidly progress to severe respiratory distress.

Asymptomatic the night prior to onset.

No spontaneous cough.

The child is apprehensive.

Voice is muffled with a froglike croaking sound on inspiration.

Sore throat, reddened and inflamed.

Drooling.

Agitation.

Fever.

Dysphagia.

Suprasternal.

Substernalretractions.

 Respiratory obstruction develops quickly and may lead to

• Hypoxia


• Acidosis


• Reduced level of consciousness


• Sudden death
  The key difference between laryngotracheobronchitis (LTB) and epiglottitis
  is the presence of a cough in LTB.

Test Results

Positive for Haemophilus influenzae

Chest films

WBC with differential count

Treatment

Intensive observation by experience personnel.

Endotracheal intubation.

Tracheostomy.

All invasive procedures should be performed in the operating room or

areas equipped to initiate immediate intubation.

Antibiotic therapy.

Nursing Interventions

Reassure the child and family to reduce anxiety.

Avoid assessment of the oral cavity with a tongue blade.

Allow the child to remain in the caregiver’s lap and in the position that

is most comfortable.

Nursing alertThe onset of epiglottitis is abrupt and can rapidly progress

to severe respiratory distress. The obstruction is supraglottic as opposed to sub-

glottic as in laryngitis. This disorder requires immediate attention.

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(^78) Pediatric Nursing Demystified