An 18-month-old child is brought to the emergency room with difficulty breathing. The physician diagnoses the child with epiglottitis
Which of the following findings by the nurse are consistent with this diagnosis? Standard Text: Select all that apply. 1. Oxygen saturation level is 85% on room air.
2. Respiratory rate is 22 per minute.
3. Stridor is audible without stethoscope.
4. Apical heart rate is 72 beats per minute.
5. Temperature is 103.7 degrees Fahrenheit.
1,3,5
Rationale 1: Oxygen saturation level is 85% on room air. The child with epiglottitis may have a decreased oxygen saturation level. 85% is lower than normal.
Rationale 2: Respiratory rate is 22 per minute. The respiratory rate is normal for a child between 1 and 2 years old. The child with epiglottitis will more likely exhibit an increased respiratory rate.
Rationale 3: Stridor is audible without stethoscope. Audible stridor is associated with epiglottitis.
Rationale 4: Apical heart rate is 72 beats per minute. The child's heart rate is within normal limits for the child's age.
Rationale 5: Temperature is 103.7 degrees Fahrenheit. The child has a high fever and this is associated with epiglottitis.
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