Question

The nurse is caring for a client admitted with acute laryngotracheobronchitis (LTB). Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available? A. Intravenous access supplies B. Emergency intubation equipment C. Intravenous fluid administration pump D. Supplemental oxygen

Short answer

Answer: Emergency intubation equipment.

Step-by-step solution

Understand Acute Laryngotracheobronchitis (LTB)

Acute laryngotracheobronchitis (LTB) is an upper respiratory infection that can cause inflammation and narrowing of the airway, which may lead to difficulty breathing and even complete airway obstruction in severe cases. When treating a patient with LTB, it's crucial to be prepared for the potential risks of airway obstruction.

Option A: Intravenous access supplies

Intravenous access supplies are essential for administering medications, fluids, and nutrition. However, they don't directly address the issue of airway obstruction and managing the patient's ability to breathe.

Option B: Emergency intubation equipment

Emergency intubation equipment is used to establish an artificial airway in situations where the patient's airway is obstructed or compromised. This equipment is critical for managing a complete airway obstruction, which might occur in a patient with LTB.

Option C: Intravenous fluid administration pump

An intravenous fluid administration pump is used to manage the rate and flow of fluids in intravenous therapy. While useful in various medical scenarios, it doesn't directly address the issue of airway obstruction and managing the patient's ability to breathe.

Option D: Supplemental oxygen

Supplemental oxygen can be helpful in supporting a patient's breathing and maintaining adequate oxygen levels. However, in the case of complete airway obstruction, supplemental oxygen may not effectively reach the patient's lungs and does not directly address the main issue.

Choose the best option

Based on the analysis of the four options: - Option A (Intravenous access supplies) doesn't directly address airway obstruction. - Option B (Emergency intubation equipment) is critical for managing airway obstruction. - Option C (Intravenous fluid administration pump) doesn't directly address airway obstruction. - Option D (Supplemental oxygen) doesn't directly address a complete airway obstruction. Therefore, the correct answer is B. Emergency intubation equipment should be available when caring for a client with acute laryngotracheobronchitis (LTB) to manage the potential risk of complete airway obstruction.

Key concepts

Acute Laryngotracheobronchitis

Acute laryngotracheobronchitis, often referred to as LTB or croup, is a common respiratory condition, especially in young children. It is characterized by inflammation of the larynx, trachea, and bronchi. This inflammation leads to swelling and narrowing of the airway, making it difficult for the affected person to breathe. The hallmark symptoms include a barking cough, stridor (a high-pitched wheezing sound), and hoarseness. In severe cases, the airway can become completely obstructed, leading to a medical emergency. Recognizing the early signs of LTB is crucial for initiating prompt treatment and preventing complications such as respiratory distress or failure.

• Barking cough and stridor are key symptoms indicating the condition.
• Occurs primarily in children aged 6 months to 3 years.
• Viruses are often the underlying cause.
• Quick assessment and action are critical to managing symptoms and preventing severe outcomes.

Nursing Procedures

When dealing with acute laryngotracheobronchitis, nurses play a crucial role in monitoring and managing the patient's condition. Nursing procedures focus primarily on assessing the patient's respiratory status regularly and ensuring that the airway remains open. This involves monitoring breathing patterns, listening for abnormal respiratory sounds, and observing for signs of increased respiratory effort or distress. Nursing care also includes providing comfort and reassurance to the patient and family to help ease anxiety, as anxiety can exacerbate breathing difficulties.
Effective nursing practices might include:

• Frequently assessing airway patency.
• Using a calm and soothing approach when interacting with the patient and family.
• Ensuring the availability of life-saving equipment.
• Educating caregivers on recognizing early symptoms and when to seek help.

It's essential for nurses to be vigilant, as the condition can worsen suddenly. Quick access to emergency interventions can prevent complications.

Airway Management

Airway management is a critical component in the care of patients with acute laryngotracheobronchitis. The primary goal is to maintain a clear and open airway to ensure adequate ventilation and oxygenation. In cases of partial obstruction, supplementary oxygen may be provided to support breathing. However, with the risk of complete airway obstruction in severe cases, emergency intubation becomes necessary.
Key steps in airway management involve:

• Continuously assessing the patient's respiratory effort and adequacy of ventilation.
• Keeping emergency intubation equipment readily accessible.
• Employing non-invasive methods such as positioning to enhance airway patency.
• Providing humidified air to help reduce airway dryness and irritation.

Effective airway management ensures that even in the event of an airway compromise, the risk of complications like hypoxemia or respiratory arrest is minimized.

Emergency Medical Equipment

Having the appropriate emergency medical equipment on hand is vital when caring for patients with conditions like acute laryngotracheobronchitis. In case of a sudden airway obstruction, the availability of emergency intubation equipment can be life-saving. This equipment includes laryngoscopes, endotracheal tubes, and bag-valve-mask setups to establish and maintain an artificial airway.
Essential emergency equipment includes:

• Emergency intubation kits for immediate airway access.
• Oxygen delivery systems, such as masks and nasal cannulas.
• Suction devices to clear the airway of secretions.
• Monitoring devices, like pulse oximeters, to assess oxygen levels continuously.

Nurses and healthcare providers must be well-trained to use these tools efficiently. This preparedness decreases response time and improves patient outcomes during critical situations.