LARYNGOTRACHEOBRONCHITIS

LARYNGOTRACHEOBRONCHITIS

Description

– Is the most common cause of a croup and typically affects children younger than 5 years old

– Inflammation of the larynx, trachea, and bronchi

– Most common type of croup and may be viral or bacterial

– Gradual onset that may be preceded by an upper respiratory infection.

Assessment

– fever, low-grade to high

– irritability and restlessness

– hoarse voice

– seal bark and brassy cough

– inspiratory stridor and suprasternal retraction

– use of accessory muscles for breathing

– crackles and wheezing on lung auscultation

– anorexia, nausea, and vomiting

– cyanosis

           – upper respiratory infection

Interventions

– maintain a patent airway

– assess respiratory status, monitoring for nasal flaring, sternal reaction, and inspiratory stridor

– monitor for pallor or cyanosis

– elevate the head of the bed and provide bed rest

– provide humidified oxygen via cool-mist tent for the hospitalized child

– instruct the parents to use a cool-air vaporizer or humidifier at home; other measures include having the child breathe in the cool night air or air from an open freezer or taking the child to a cool basement or garage.

– provide and encourage fluid intake; intravenous fluids may be prescribed to maintain hydration status if the child is unable to take fluids orally.

– administer nebulized epinephrine (racemic epinephrine) as prescribed for children with severe disease, stridor at rest, retractions, or difficlty breathing.

– administer antibiotics as prescribed, nothing that they are not indicated unless a bacterial infection is present have resuscitation equipment available