5 Epiglottitis Nursing Care Plans

Learn about nursing diagnosis and care plans for epiglottitis in adults and children with our comprehensive guide. Discover assessment and diagnostic criteria, as well as effective nursing interventions and nursing management strategies for epiglottitis.

What is Epiglottitis?

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, and rapid respirations and prefer 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 patterns are usually re-established within 72 hours following intubation and antimicrobial regimen.

Nursing Care Plans

Nursing care planning goals of a child with epiglottitis consist 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:

  1. Ineffective Airway Clearance
  2. Hyperthermia
  3. Anxiety
  4. Deficient Knowledge (Preventive Care)
  5. Risk For Suffocation

Ineffective Airway Clearance

Epiglottitis is a condition where the epiglottis, which covers the trachea during swallowing, becomes swollen and obstructs the airway. This obstruction can lead to ineffective airway clearance due to the increased production of mucus and edema in the upper airways, making it difficult for the patient to breathe properly.

Nursing Diagnosis

  • Ineffective Airway Clearance

May be related to

  • Obstruction associated with edema and excessive mucus production in the upper airways

Possibly evidenced by

  • Sudden high fever
  • Muffled voice
  • Sore throat
  • Dyspnea
  • Drooling
  • Dysphagia
  • Decreased breath sounds
  • Rapid breathing with respiratory distress
  • Bright red epiglottis with edema

Desired Outcomes

  • The child’s airway will maintain a patent airway with improved airway clearance, as evidenced by clear breath sounds, normal respiratory rate, and adequate oxygenation.
  • The child will demonstrate a reduction in signs and symptoms of respiratory distress, such as retractions, and the use of accessory muscles.

Nursing Assessment and Rationales

1. Assess respiratory rate, effort, pattern, and depth.
Nasal flaring, rapid breathing, dyspnea, chest retractions, and apnea are signs of severe respiratory distress that may require immediate airway support. These symptoms may indicate that the patient is struggling to breathe and may require interventions such as oxygen therapy, mechanical ventilation, or airway management.

2. Auscultate lungs for the presence of normal or adventitious lung sounds.
Absent or decreased lung sounds may reveal the presence of a mucous plug or airway obstruction. Stridor is a late ominous sign of epiglottitis that indicates emergency airway management.

3. Use pulse oximetry to monitor oxygen saturation; assess arterial blood gases (ABGs).
Pulse oximetry is used to detect changes in oxygenation. Oxygen saturation should be maintained at 90% or greater. Alteration in ABGS may result in increased pulmonary secretions and respiratory fatigue.

Nursing Interventions and Rationales

1. Encourage oral intake by offering warm, clear fluids.
Adequate hydration liquefies thick mucus/secretions.

2. Position the child in a sitting up and leaning forward position with mouth open and tongue out (“tripod” position).
Allows maximum entry of air into the lungs for improved oxygenation.

3. Keep suction equipment readily available.
Suction equipment should be readily available at the bedside to clear any secretions or debris that may obstruct the airway.

4. Advice parents to limit the patient’s activities such as excessive movement or talking.
Any activity that causes the patient to become agitated can worsen respiratory distress by increasing the demand for oxygen.

5. Administer humidified oxygen
Children need moist air to decrease epiglottal inflammation and facilitate expectoration.

6. Administer IV antibiotics as ordered.
After obtaining blood and epiglottic cultures, second-or-third generation cephalosporins and beta-lactamase-resistant antibiotic should be started as soon as possible.

7. Administer corticosteroids (Dexamethasone) as ordered.
Corticosteroids work by decreasing inflammation and swelling in the upper airways, which can help to relieve the airway obstruction and improve breathing. Corticosteroids are often used in combination with antibiotics, which are also typically prescribed to treat bacterial infections that can cause epiglottitis.

8. Prepare for intubation or tracheostomy; Anticipate the need for an artificial airway.
An artificial airway is required to promote oxygenation and ventilation and prevent aspiration.

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:

Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.

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