The nurse performs an assessment of a child with pertussis (whooping cough). Which finding would the nurse identify as indicative of a potential complication?
A.
A urinary output of 30 mL/hr
B.
A white blood cell (WBC) count of 10.000 mm3 (10×109/L)
C.
Decreased breath sounds in the lung bases
D.
A weight gain
The Correct Answer and Explanation is:
The correct answer is C. Decreased breath sounds in the lung bases.
Explanation:
Pertussis, commonly known as whooping cough, is a highly contagious bacterial infection caused by Bordetella pertussis. The disease is characterized by severe coughing fits that can lead to significant respiratory distress. Complications can arise, especially in children, due to the intensity of coughing and the associated strain on the respiratory system.
Option A: A urinary output of 30 mL/hr – Urinary output of 30 mL/hr is within normal ranges for children. Normal urinary output in children varies with age, but a general guideline is 1 mL/kg/hr. Therefore, unless the child is very small, this urinary output does not typically indicate a complication.
Option B: A white blood cell (WBC) count of 10,000 mm³ (10×10⁹/L) – A WBC count of 10,000 mm³ is considered to be within the normal range for a child. Normal WBC counts can vary, but this value does not suggest an immediate complication related to pertussis.
Option C: Decreased breath sounds in the lung bases – Decreased breath sounds in the lung bases are a significant finding that can indicate a potential complication of pertussis. These decreased breath sounds may suggest the presence of complications such as pneumonia, atelectasis (lung collapse), or the accumulation of secretions that are not being effectively cleared due to severe coughing. Pneumonia is a common complication of pertussis and can be identified by abnormal breath sounds and decreased air entry on auscultation.
Option D: A weight gain – Weight gain, in general, is not an indicator of a complication of pertussis. In fact, a child with pertussis might have weight loss due to increased energy expenditure from coughing fits and decreased intake due to illness.
In summary, decreased breath sounds in the lung bases can be an early sign of respiratory complications, such as pneumonia, which are serious concerns in children with pertussis. This finding warrants further investigation and potentially immediate intervention to prevent severe respiratory distress or deterioration.