The nurse cares for a child diagnosed with laryngotracheobronchitis who is assessed to have worsening inspiratory stridor with an oxygen saturation of 92% on room air. The nurse should obtain a prescription for which medication?A. Formoterol via dry powder inhalerB. Nebulized racemic epinephrineC. Albuterol via nebulizerD. Oral montelukast
Question
The nurse cares for a child diagnosed with laryngotracheobronchitis who is assessed to have worsening inspiratory stridor with an oxygen saturation of 92% on room air. The nurse should obtain a prescription for which medication?A. Formoterol via dry powder inhalerB. Nebulized racemic epinephrineC. Albuterol via nebulizerD. Oral montelukast
Solution
The correct answer is B. Nebulized racemic epinephrine.
Here's why:
Laryngotracheobronchitis, also known as croup, is a common respiratory illness in children that causes inflammation and swelling of the larynx, trachea, and bronchi. This can lead to symptoms such as a barking cough, hoarseness, and difficulty breathing.
Inspiratory stridor is a high-pitched, wheezing sound caused by disrupted airflow. Stridor may also be called musical breathing or extrathoracic airway obstruction.
The child's oxygen saturation of 92% on room air indicates that they are not getting enough oxygen.
In this situation, the nurse should obtain a prescription for nebulized racemic epinephrine. This medication can help to reduce swelling in the airway and improve breathing.
Formoterol via dry powder inhaler (option A) is a long-acting bronchodilator used to prevent bronchospasm in people with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema. It is not typically used in acute situations or in children with croup.
Albuterol via nebulizer (option C) is a bronchodilator that relaxes muscles in the airways and increases air flow to the lungs. It is used to treat or prevent bronchospasm in people with reversible obstructive airway disease. However, it is not the first-line treatment for croup.
Oral montelukast (option D) is a leukotriene receptor antagonist that is used to prevent asthma attacks and to relieve allergy symptoms. It is not typically used to treat croup.
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