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