Health Promotion and Maintenance
90. The parents of a child recently discharged with acute spasmodic laryngitis contact a nurse to report that the child continues to have croupy coughing spells at nighttime but is otherwise fine. What should the nurse recommend?
. Contact the child's physician for another round of antibiotics.
. Treat the spasms by sitting in the bathroom while a hot shower runs.
. Bring the child back to the emergency department as soon as possible.
. Elevate the child's head at bedtime using pillows.
Test-Taking Tip
Note that the word "spasmodic" in the stem of the question is also in the correct answer ("spasms").
Content Area: Child Health, Respiratory; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Alterations in Body Systems
Health Promotion and Maintenance
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Answer 1 is incorrect since croup is caused by a virus and is not treatable with antibiotics. Answer 2 is correct because the humidity of the shower will create an environment that is soothing to the child's airway. Cool-mist humidifiers are also recommended for the child's room to relieve the symptoms of spasmodic croup. Any of the croup syndromes may be treated with humidified air. In the case of acute spasmodic laryngitis, both warm mist and cool mist are acceptable interventions since the problem is airway spasm rather than severe inflammation. Answer 3 is incorrect because paroxysmal attacks may last for some time; the child is best treated with supportive care at home, and the presence of attacks is not an indication for further hospitalization. Answer 4 is incorrect because this intervention is not likely to prevent laryngeal spasms and may cause the child to be more anxious, which could induce an attack.