Choice A rationale:

Croup typically presents with a barking cough, hoarseness, and inspiratory stridor, which are caused by inflammation of the larynx, trachea, and bronchi.

This choice is incorrect.

Choice B rationale:

The patient's symptoms, including inspiratory stridor, hoarseness, and rapid deterioration, are indicative of epiglottitis, a serious bacterial infection that can cause airway obstruction.

It is a medical emergency requiring urgent intervention.

This choice is correct.

Choice C rationale:

Asthma is characterized by chronic inflammation and narrowing of the airways, leading to symptoms such as wheezing and shortness of breath.

The absence of wheezing in this patient makes this choice incorrect.

Choice D rationale:

Pneumonia can cause fever, cough, and shortness of breath, but it usually presents with focal findings on lung examination, such as crackles or decreased breath sounds.

The absence of these findings in this patient makes this choice incorrect.

Choice A rationale:

High fever is not a typical symptom of croup.

Croup is often caused by viral infections, and high fever is more commonly associated with bacterial infections.

This choice is incorrect.

Choice B rationale:

Inspiratory stridor is a classic symptom of croup and is caused by the narrowing of the larynx and trachea, leading to a high-pitched sound during inspiration.

This choice is correct.

Choice C rationale:

A barking cough is a distinctive symptom of croup and is caused by inflammation of the larynx and trachea.

This choice is correct.

Choice D rationale:

Wheezing is not a typical symptom of croup.

Wheezing is more commonly associated with conditions like asthma, where there is narrowing of the smaller airways (bronchioles).

This choice is incorrect.

Choice E rationale:

Respiratory distress, indicated by increased work of breathing, is a common symptom of croup.

It can manifest as the use of accessory muscles, intercostal retractions, and nasal flaring.

This choice is correct.

The nurse should assess the degree of airway obstruction to determine the severity of respiratory distress.

Choice A rationale:

Assessing the child's height and weight is important for overall health assessment but does not specifically determine the severity of respiratory distress in croup.

Respiratory distress is primarily evaluated by assessing airway patency, effort of breathing, and oxygenation.

Choice B rationale:

The child's vaccination history is crucial for preventing certain infectious diseases, but it does not directly assess the severity of respiratory distress in croup.

Croup is commonly caused by viral infections such as parainfluenza viruses.

Choice C rationale:

Assessing the degree of airway obstruction is essential in determining the severity of respiratory distress in croup.

Children with croup often present with stridor, a high-pitched sound heard during inspiration, indicating partial airway obstruction.

The severity of stridor, along with signs of increased work of breathing, provides valuable information about the child's respiratory status.

Choice D rationale:

The child's social activities are not directly related to the assessment of respiratory distress in croup.

While social history is important in a comprehensive nursing assessment, it does not provide specific information about the severity of airway obstruction in croup.

Nursing interventions for a child with croup include providing cool mist humidification, administering bronchodilators, and administering corticosteroids.

Choice A rationale:

Administering antibiotics is not a standard intervention for croup unless there is a secondary bacterial infection present.

Croup is typically caused by viral infections, so antiviral medications might be considered if the cause is identified as a specific virus.

However, antibiotics do not directly address the symptoms of croup.

Choice B rationale:

Providing cool mist humidification is appropriate for a child with croup.

Cool mist helps soothe the inflamed airways and can alleviate respiratory distress by reducing airway edema.

Moist air can make breathing easier for the child.

Choice C rationale:

Administering bronchodilators can be beneficial in the treatment of croup, especially if there is evidence of bronchoconstriction.

Bronchodilators help dilate the airways, making breathing easier for the child.

This intervention can be particularly useful if the child is experiencing wheezing in addition to stridor.

Choice D rationale:

Administering corticosteroids, such as dexamethasone, is a common and evidence-based intervention for croup.

Corticosteroids reduce airway inflammation and edema, leading to symptom improvement.

A single dose of oral corticosteroids is often sufficient to manage croup symptoms effectively.

Choice E rationale:

Encouraging the child to cough loudly is not a recommended intervention for croup.

Coughing forcefully may exacerbate airway irritation and inflammation, worsening the child's symptoms.

Instead, interventions should focus on reducing airway edema and providing respiratory support.

The nurse should assess the child's vital signs and listen to his lungs.

Choice A rationale:

Assessing vital signs, including heart rate, respiratory rate, oxygen saturation, and temperature, is essential in evaluating the child's overall condition and the severity of respiratory distress.

Listening to the child's lungs can help identify abnormal breath sounds, such as stridor or wheezing, which are common in croup.

This information guides further interventions and helps determine the appropriate level of care.

Choice B rationale:

While croup can cause respiratory distress, not every case requires an emergency room visit.

The severity of symptoms, including the child's ability to breathe and oxygenate, should guide the decision to seek emergency care.

In this scenario, assessing vital signs and lung sounds is the initial appropriate action.

Choice C rationale:

Croup is a treatable condition, and there are specific interventions, such as providing humidified air and corticosteroids, that can alleviate symptoms and prevent complications.

It is incorrect to tell the parent that there is nothing that can be done for croup.

Medical intervention can significantly improve the child's condition.

Choice D rationale:

Croup is primarily caused by viral infections, not bacterial infections.

Administering antibiotics without confirming a bacterial infection is inappropriate and contributes to antibiotic resistance.

Choice A rationale:

This statement does not indicate a complete understanding of croup.

Croup is not just a cold that affects the throat; it specifically involves inflammation of the upper airway.

Choice B rationale:

This statement acknowledges that croup can be serious but usually resolves on its own.

While this is true, it does not encompass the key symptoms and actions the parent should take if the child's condition worsens.

Choice C rationale:

This statement addresses general cold symptoms but does not specifically mention the characteristic symptoms of croup, such as barking cough, hoarseness, and stridor.

Choice D rationale:

This is The correct answer.

It shows an understanding of the symptoms of croup, particularly the mention of having trouble breathing, which is a sign of severe croup that requires medical attention.

Parents should seek emergency medical care if their child experiences difficulty breathing due to croup.

Providing this information demonstrates a comprehensive understanding of the condition.

Choice A rationale:

Administering oxygen therapy is essential in cases of severe croup where the child has difficulty breathing.

Oxygen therapy helps ensure adequate oxygenation, which is crucial in managing respiratory distress.

Choice B rationale:

Positioning the child upright facilitates breathing by allowing the airways to remain open and reducing airway obstruction.

This position helps alleviate symptoms like stridor and allows the child to breathe more comfortably.

Choice C rationale:

Providing humidified air helps loosen secretions and makes it easier for the child to breathe.

Humidification can reduce airway irritation and soothe the inflamed throat, providing relief from croup symptoms.

Choice D rationale:

This choice is incorrect because encouraging the child to drink plenty of fluids is generally good advice for any illness but is not specific to croup.

While it is essential to keep the child hydrated, it is not a direct nursing intervention for managing croup symptoms.

Choice E rationale:

Monitoring the child's respiratory status closely is crucial in assessing the effectiveness of the interventions and identifying any signs of respiratory distress.

Close monitoring allows nurses to make timely decisions and take appropriate actions to maintain the child's respiratory function.

Choice A rationale:

While giving the child plenty of water and juice is important for hydration, this statement does not address the specific management of croup symptoms.

Choice B rationale:

Running a hot shower and letting the child sit in the bathroom can create a steamy environment, but it is not the most effective way to provide humidified air.

A cool mist humidifier is a more controlled and efficient method for delivering humidified air to the child.

Choice C rationale:

This is The correct answer.

Using a cool mist humidifier in the child's bedroom is an appropriate way to provide humidified air, which can help ease breathing difficulties associated with croup.

Cool mist humidifiers add moisture to the air without heating it, making it easier for the child to breathe and reducing throat irritation.

Choice D rationale:

Giving the child a warm bath may provide some comfort but does not specifically address the need for humidified air, which is crucial in managing croup symptoms.

Providing humidified air helps soothe the inflamed airways and reduce respiratory distress associated with croup.

Choice A rationale:

Continuing to monitor the child's respiratory status may not be the best action in this situation, as the child's respiratory status is worsening and they are becoming increasingly agitated.

Immediate intervention is required to alleviate the child's distress.

Choice B rationale:

Administering oxygen therapy as needed is a supportive measure in respiratory distress situations, but in the case of severe croup with worsening respiratory status and agitation, nebulized epinephrine is the treatment of choice to reduce airway inflammation and improve breathing.

Choice C rationale:

Nebulized epinephrine is the primary treatment for severe croup as it helps reduce upper airway edema, relieve stridor, and improve respiratory distress.

It acts by causing vasoconstriction, which reduces swelling in the upper airway, making breathing easier for the child.

Therefore, preparing to administer nebulized epinephrine is the most appropriate action in this situation.

Choice D rationale:

Notifying the physician immediately is essential, but immediate intervention to improve the child's respiratory distress is also necessary.

Nebulized epinephrine should be administered promptly to alleviate the child's symptoms and prevent further deterioration.

Choice A rationale:

Placing the child on a ventilator might be necessary in severe cases of croup, but it should not be the first action taken.

In this scenario, the child has moderate croup, so less invasive interventions should be attempted first.

Choice B rationale:

Administering medication to help the child's cough and breathing is an appropriate first step in managing moderate croup.

Nebulized epinephrine or corticosteroids are commonly used to reduce airway inflammation and relieve respiratory distress in croup.

This intervention can be effective in improving the child's symptoms and overall condition.

Choice C rationale:

Transferring the child to the ICU for closer monitoring is not immediately necessary in this case of moderate croup.

Such a step might be considered if the child's condition worsens despite initial interventions or if there are signs of severe respiratory distress.

Choice D rationale:

Discharging the child home without appropriate treatment and monitoring would be unsafe, given the child's symptoms and oxygen saturation level.

Immediate intervention and observation are required to ensure the child's respiratory status improves.

Choice A rationale:

Croup is indeed a common viral infection of the upper respiratory tract that causes inflammation of the larynx.

This statement is accurate and important for the parent to understand the nature of the illness.

Choice B rationale:

Croup is most common in children under the age of 5, not just under the age of 3.

However, this statement is not entirely accurate, as older children can also be affected by croup.

It is essential to provide correct information to the parent.

Choice C rationale:

The symptoms of croup often worsen at night due to the natural narrowing of the airways during sleep, making breathing more difficult.

Therefore, this statement is correct and relevant to include in the teaching.

Choice D rationale:

The classic croup cough is indeed described as a barking cough, which results from the inflammation of the larynx and trachea.

This description helps the parent recognize a distinctive symptom of croup.

Including this information in the teaching is appropriate.

Choice E rationale:

Croup is primarily managed with supportive care, such as humidified air and nebulized medications.

Over-the-counter cough syrup and expectorants are not typically recommended for treating croup in children.

This statement is incorrect and should not be included in the teaching.

Choice A rationale:

An oxygen saturation level of 95% is within the normal range (normal range is typically 95-100%).

While it is essential to monitor oxygen saturation, this value does not indicate worsening of the child's condition.

Choice B rationale:

A respiratory rate of 30 breaths per minute is above the normal range for a child and can indicate respiratory distress.

An increased respiratory rate is a concerning sign, suggesting the child is having difficulty breathing.

This finding indicates the child's condition is worsening and requires prompt attention.

Choice C rationale:

Mild retractions suggest that the child is working harder to breathe but may not necessarily indicate a severe worsening of the condition.

Retractions are a sign of increased respiratory effort but may vary in severity.

Choice D rationale:

A child with croup experiencing severe respiratory distress may not be able to speak in complete sentences due to the difficulty in breathing.

However, the ability to speak in complete sentences alone may not be a definitive indicator of worsening.

Monitoring the respiratory rate and effort is crucial in assessing the child's condition accurately.

Choice A rationale:

There is no vaccine to prevent croup, but practicing good hand hygiene and avoiding contact with sick people can help reduce the child's risk of getting croup.

Croup is mainly caused by viral infections, so minimizing exposure to viruses is essential in prevention.

Choice B rationale:

Giving a daily dose of vitamin C is not a proven method for preventing croup.

While vitamin C is essential for overall health, it does not specifically prevent croup.

Providing accurate and evidence-based information is crucial in parental education.

Choice C rationale:

Keeping the child's bedroom cool and humid may provide comfort during the illness, but it is not a proven method for preventing croup.

This statement does not contribute significantly to preventive measures against croup.

Choice D rationale:

Using a humidifier in the home can help maintain adequate humidity levels, which may reduce the risk of croup, especially during dry seasons.

Proper humidity can prevent irritation of the upper respiratory tract and decrease the likelihood of developing croup.

Including this information in the teaching is appropriate and beneficial for the parent to know.