A nurse is caring for a toddler who has laryngotracheobronchitis. For which of the following findings should the nurse monitor to detect airway obstruction?
A.
Decreased stridor
B.
Increased restlessness
C.
Decreased heart rate
D.
Decreased temperature
The Correct Answer and Explanation is:
The correct answer is B. Increased restlessness.
Explanation
Laryngotracheobronchitis (LTB), commonly known as croup, is an upper airway infection primarily affecting toddlers. It is characterized by inflammation and swelling of the larynx, trachea, and bronchi, which can lead to significant airway obstruction. Monitoring for signs of airway obstruction is critical in managing this condition to ensure timely intervention.
Increased Restlessness:
Restlessness in a toddler with LTB is a significant indicator of worsening respiratory distress and potential airway obstruction. As the airway becomes obstructed or narrowed due to inflammation, the child may become increasingly anxious and restless. This restlessness can be attributed to the child’s struggle to breathe effectively. It signals that the child’s airway might be compromised, and immediate assessment and intervention are required. The child’s restlessness often precedes more severe symptoms and provides a crucial early warning for healthcare providers to initiate appropriate treatment, such as administering corticosteroids or nebulized epinephrine, and possibly considering more advanced interventions if necessary.
Other Options:
- Decreased Stridor: Stridor is a high-pitched, wheezing sound caused by turbulent airflow through a narrowed upper airway. In cases of LTB, stridor typically worsens with increased airway obstruction. A decrease in stridor may indicate that the airway swelling has improved or that the child is not breathing as effectively, which is not necessarily a sign of improved condition.
- Decreased Heart Rate: A decreased heart rate (bradycardia) is generally a concerning sign, especially in the context of respiratory distress. It is not typically associated with the initial signs of airway obstruction but may occur in severe cases where hypoxia (low oxygen levels) has progressed significantly. Thus, monitoring heart rate alone is not a reliable indicator of airway obstruction in LTB.
- Decreased Temperature: While a fever can be associated with infections like LTB, a decrease in temperature is not a direct indicator of airway obstruction. In fact, temperature changes are less specific to airway obstruction compared to signs of respiratory distress.
In summary, increased restlessness is a key observation for detecting potential airway obstruction in a toddler with LTB, highlighting the need for immediate evaluation and intervention.