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
Risk For Suffocation
Risk For Suffocation: Accentuated risk of accidental suffocation (inadequate air available for inhalation).
May be related to
- Disease process
Possibly evidenced by
- Extreme anxiety, with struggle to breathe
- Supraglottic edema
- Preventive measures are exerted to maintain a patent airway.
- Child’s airway remains open either naturally or by means of ET tube or tracheostomy.
|Assess for changes in skin color from pallor to cyanosis, severe dyspnea|
and sternal and intercostal retractions, lethargy, increased pulse.
|Provides information about increasing airway obstruction.|
|Discourage examining throat with a tongue blade or taking throat culture unless immediate emergency equipment and personnel at hand.||Leads to laryngospasm and airway obstruction.|
|Allow to sit up and avoid lying position.||Lying down may cause epiglottis to fall backward, causing airway obstruction.|
|Monitor oxygenation via pulse oximeter; Provide oxygen as prescribed.||Promotes oxygenation of tissues and prevents hypoxemia.|
|Endotracheal intubation must be readily available; assist with tracheostomy if needed or prepare for the procedure in surgery.||Establishes airway if obstruction present and respiratory failure and asphyxia is imminent.|
|Provide a brief clear explanation of|
care and all procedures and purpose and procedure for emergency intubation or tracheostomy if required while hospitalized.
|Explanations provide information and support for parents who are unfamiliar with the care.|
|Inform parents of the rationale for|
restraints if an emergency procedure is done, that swelling is reduced after 24 hours of therapy and ET tube will probably be removed after 3 days.
|Prepares parents with information of what to expect.|
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