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
Anxiety: Vague uneasy feeling of discomfort or dread accompanied by an autonomic response.
May be related to
- Change in the health status of the child
- Change in the environment (hospitalization)
- Change in role functioning (parenting)
Possibly evidenced by
- Verbalization of extreme fear and anxiety by parents
- Extreme expression of fear [child]
- Air hunger
- Parents will verbalize decreased anxiety.
- Child will appear calm without agitation, crying or irritability.
|Assess severity of fear and anxiety of parents and child.||Provides information regarding the presence of severe anxiety as symptoms of the disease become more acute and breathing more difficult.|
|Provide a calm and supportive environment and reassure parents that amplest care is being given to the child.||Provides reassurance and lessens the anxiety of parents.|
|Encourage parents to stay with the child, provide a place for rest.||Promotes security needs for child and assists in decreasing parental anxiety.|
|Remain with the child at all times during acute stages.||Provides continuous evaluation for emergency interventions and reassurance for parents.|
|Maintain the child in a tripod position; Allow a familiar object (toy, blanket) during the hospitalization.||Promotes position of comfort and security for the child.|
|Educate parents regarding procedures, treatment, and modifications in the child’s condition.||Reduces anxiety caused by fear of the unknown.|
|Avoid any measures or procedures that are not needed during the acute stage.||Prevents raise of anxiety which increases respiratory distress.|
|Provide orientation to parents and child about the room, equipment, supplies, and policies.||Familiarizes them to the hospital environment.|
|Encourage expression of fears and feelings|
of parents and child and for caused by severe behaviors anxiety.
|Lessens anxiety and humiliation.|
|Allow the child to remain seated on parent’s lap during all care, including lateral neck X-ray if ordered.||Decreases anxiety of the child and avoids precipitating a complete obstruction.|
|Educate parents that swelling subsides 24 hours after antibiotic therapy is started and epiglottis usually returns to normal in about 3 days.||Provides evidence of positive outcome and reduces anxiety.|
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