Page 1021 - Saunders Comprehensive Review For NCLEX-RN

CHAPTER 35

Respiratory Problems

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Priority Concepts
Gas Exchange; Health Promotion

I. Epiglottitis
A. Description
1. Bacterial form of croup
2. Inflammation of the epiglottis occurs, which may be
caused by Haemophilus influenzae type b or
Streptococcus pneumoniae; children immunized with H.
influenzae type b (Hib vaccine) are at less risk for
epiglottitis.
3. Occurs most frequently in children 2 to 8 years old,
but can occur from infancy to adulthood
4. Onset is abrupt, and the condition occurs most often in
winter.

5. Considered an emergency situation because it

can progress rapidly to severe respiratory distress.
B. Assessment
1. High fever

2. Sore, red, and inflamed throat (large, cherry

red, edematous epiglottis) and pain on swallowing
(Fig. 35-1)
3. Absence of spontaneous cough

4. Dysphonia (muffled voice), dysphagia,

dyspnea, and drooling
5. Agitation
6. Retractions as the child struggles to breathe
7. Inspiratory stridor aggravated by the supine position
8. Tachycardia
9. Tachypnea progressing to more severe respiratory
distress (hypoxia, hypercapnia, respiratory acidosis,
decreased level of consciousness)

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