A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus influenzae type B. Which of the following actions should the nurse take? Select all that apply.
Explanation & Rationale
The correct answers are Choices C, D, and E. Choice A rationale Obtaining a throat culture is not recommended for a child with epiglottitis due to Haemophilus influenzae type B because it can cause further airway obstruction and distress. Choice B rationale Inspecting the epiglottis is not advisable as it can cause further airway obstruction and distress. Visualization of the epiglottis should be done in a controlled environment, such as an operating room, by a specialist. Choice C rationale Beginning droplet precautions is essential for preventing the spread of Haemophilus influenzae type B, which is transmitted through respiratory droplets. Choice D rationale Monitoring oxygen saturation is crucial for assessing the child’s respiratory status and ensuring adequate oxygenation. Choice E rationale Initiating IV access is necessary for administering medications and fluids to manage the child’s condition effectively.