Question

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A 3 year old boy comes in with two day history of cough, runny nose and low grade fever, usually around 102F. Dad has been treating with tylenol and ibuprofen as needed, but tonight the patient started having a cough that dad describes as "barking". You are concerned for croup- specifically acute laryngothracheobronchitis.

A. What would you anticipate finding on his assessment with croup?

B. What treatment would you anticipate the physician ordering with this patient?

C. Would you expect medications to be ordered for this patient? If so, which ones?

Answer 1

A.The following things can be anticipated in the assessment

• Auscultation :stridor
• Physical examination: barking cough
• Hoovers sign is a typical indicator where during inspiration the lower rib cage moves inward
• Flu like symptoms

B.Usually it is a viral infection lasting for 3 to 5days.The patient is given symptomatic treatment like

• antipyretics to reduce temperature
• Steroids to reduce the tracheal inflammation
• Nebulisation with epinephrine can dilate bronchial tubes and enhance breathing
• Encourage the patient to be kept calm and quiet

C.Until the patient have difficulty in breathing medication will not be needed and it will settle on it's own by providing care to reduce body temperature .If the symptoms lasts more than 5 days then medication will be started with no delay generally including steroids.