Safe and Effective Care Environment Q 10

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The nurse is caring for a client admitted with epiglottitis. Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available?

  

     A. Intravenous access supplies

     B. A tracheostomy set

     C. Intravenous fluid administration pump

     D. Supplemental oxygen

    

    

Correct Answer: B. A tracheostomy set

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For a child with epiglottitis and the possibility of complete obstruction of the airway, emergency tracheostomy equipment should always be kept at the bedside. Prepare for intubation or tracheostomy; Anticipate the need of an artificial airway. An artificial airway is required to promote oxygenation and ventilation and prevent aspiration.

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Option A: Administer IV antibiotics as ordered. After obtaining blood and epiglottic cultures, second-or-third generation cephalosporins and beta-lactamase-resistant antibiotics should be started as soon as possible.

Option C: Discourage examining throat with a tongue blade or taking throat culture unless immediate emergency equipment and personnel at hand. Position the child in a sitting up and leaning forward position with mouth open and tongue out (“tripod” position). Allows maximum entry of air into the lungs for improved oxygenation.

Option D: Oxygen will not treat an obstruction. Endotracheal intubation must be readily available; assist with tracheostomy if needed or prepare for the procedure in surgery. Establishes airway if obstruction present and respiratory failure and asphyxia are imminent.

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