Epiglottitis is the acute inflammation of the epiglottis and surrounding laryngeal area with the associated edema that needs an emergency situation as the supraglottic area becomes obstructed. Commonly caused by Haemophilus influenzae type B, it affects children ages 2 to 7 years.
Children experiencing epiglottis typically appear ill with a high fever, sudden sore throat, muffled voice, rapid respirations, and prefers on sitting upright with the chin extended and mouth open. Drooling is common due to dysphagia and respiratory distress is progressive as the obstruction advances. Once epiglottitis is suspected, no examination of the oropharynx is initiated until emergency equipment and personnel are readily available.
The child may need endotracheal intubation or tracheostomy for some cases of severe respiratory distress. Onset is rapid (over 4-12 hours) and breathing pattern usually re-established within 72 hours following intubation and antimicrobial regimen.
Nursing care planning goals of a child with epiglottitis consists in providing the child with immediate emergency care to avoid the development of further complications. Other goals for the client with epiglottitis are maintaining airway patency, achieving thermoregulation, relieving anxiety, conserving energy to decrease oxygen requirements, enhancing parental/caregiver knowledge and absence of complications.
Here are five (5) nursing care plans (NCP) and nursing diagnosis for epiglottitis:
- Ineffective Airway Clearance
- Deficient Knowledge (Preventive Care)
- Risk For Suffocation
Hyperthermia: Body temperature elevated above normal range.
May be related to
- Inflammation/infection of epiglottis
Possibly evidenced by
- Sudden increase in body temperature above normal range
- Warm to touch
- Positive throat culture
- Child’s body temperature will maintain between 36.4° C- 37.5°C.
|Identify the precipitating factors.||Determination and management of the underlying cause are necessary to recovery.|
|Monitor the patient’s HR, BP, and especially the tympanic or rectal temperature.||HR and BP increase as hyperthermia progresses. Tympanic or rectal temperature gives a more accurate indication of core temperature.|
|Provide cooling measures such as lightweight clothing, decreasing room temperature, and cool compresses.||Room temperature may be accustomed to near normal body temperature and blankets and linens may be adjusted as indicated to regulate the temperature of the child.|
|Provide sufficient rest and encourage a stress-free environment.||Decreases metabolic requirements.|
|Encourage adequate fluid intake.||Fever can result in fluid loss and dehydration.|
|Raise the side rails at all times.||Ensure patient’s safety even without the presence of seizure activity.|
|Administer antipyretics (Acetaminophen) as prescribed.||Decreases fever and relieve throat pain.|
|Administer IV antibiotics as ordered.||Treats underlying cause or existing bacterial infection.|
|Teach child and family members about the signs and symptoms of hyperthermia and help in identifying factors related to the occurrence of fever.||Providing health teachings to the patient and family aids in coping with disease condition and could help prevent further complications of hyperthermia.|
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