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Epiglottitis NCLEX Mastery

jaswantkaurm@gmail.com06 mins
Epiglottitis NCLEX Mastery

Epiglottitis NCLEX Mastery Guide

Epiglottitis

What is epiglottitis? It is the inflammation of the epiglottis. This can lead to an upper airway obstruction.

Anatomy & Physiology of Epiglottis 

Epiglottitis NCLEX Mastery
Epiglottitis NCLEX Mastery

Anatomy

Location: The epiglottis is a leaf-shaped flap of cartilage located at the base of the tongue, at the entrance of the larynx (voice box). It is situated above the glottis, which is the opening between the vocal cords.

Structure:

  • Cartilage: The epiglottis is composed primarily of elastic cartilage, which provides flexibility and strength.
  • Covering: It is covered by a mucous membrane that helps protect the underlying cartilage and aids in the movement of the epiglottis.

Physiology

Function: The primary function of the epiglottis is to act as a switch between the trachea and the esophagus to ensure that food and liquids are directed into the esophagus and air is directed into the trachea.

Swallowing Mechanism:

  • Resting Position: When not swallowing, the epiglottis stands upright, allowing air to pass freely into the trachea.
  • During Swallowing: As you swallow, the larynx elevates, and the epiglottis folds backward to cover the glottis. This action prevents food and liquids from entering the trachea and directs them into the esophagus.

Protection of the Airway: By closing off the trachea during swallowing, the epiglottis protects the airway from aspiration of food and liquids, which could lead to choking or respiratory infections.

Causes of Epiglottitis

“EPI-GLOTTIS”

E E. coli and other bacteria (Streptococcus pneumoniae, Staphylococcus aureus)
P Pneumococcus (Streptococcus pneumoniae)
I Injury (direct trauma, chemical burns, thermal burns)
G Group A Streptococcus (Streptococcus pyogenes)
L Laryngitis-related viruses (e.g., varicella-zoster, herpes simplex)
O Other bacteria (Haemophilus influenzae type B – Hib)
T Thermal injury (inhaling hot steam or smoke)
T Trauma (direct throat injury)
I Immune system issues (immunosuppression, diabetes)
S Smoking and substance abuse (chronic irritation, drug inhalation)
The most common cause of epiglottitis is a bacteria that attacks the epiglottis called:
Haemophilus influenzae type B (Hib)
Prevention:
Via the Hib vaccine
When is the Hib vaccine administered?
It is part of the pediatric vaccination schedule and is given in 3-4 doses (depending on the brand used):
– At 2 months
– At 4 months
– At 6 months (if needed)
– At 12-15 months
Other Causes:
Epiglottitis can also be caused by other bacteria such as:
– Streptococcus pneumoniae
– Staphylococcus aureus
– Streptococcus pyogenes

 

Signs and Symptoms of Epiglottitis

“SORE THROAT”

S Sore throat (severe, sudden onset)
O Obstruction of airway (leading to Stridor)
R Rapid breathing (difficulty breathing)
E Elevated temperature (fever)

T Tripod position (to ease breathing)
H Hoarse voice or muffled voice
R Restlessness and anxiety (due to breathing difficulty)
O Oxygen desaturation (cyanosis)
A Ability to swallow decreased (dysphagia, drooling)
T Tachycardia (increased heart rate)

Nursing Interventions

“AIRWAY CARE”

A Airway management
I Intubation preparation
R Respiratory status monitoring
W Watch vital signs – Monitor Temperature
A Administer oxygen and medications
Y Yield throat examinations (avoid unless necessary)
Don’t use a tongue blade, oral thermometer, obtain a throat culture – This could cause a spasm, which will completely block the airway.

C Corticosteroids and antibiotics
A Assess hydration status (IV fluids)
R Reduce anxiety
E Educate patient and family

Child Care with Epiglottitis

“CALM CARE”

C Cry prevention: Prevent doing things that make the child cry.
A Avoid supine position: Allow the child to be in a comfortable position that allows them to breathe (no supine position).
L Lap of parent: Keep the child with a parent and on their lap during treatments, if possible.
M Maintain calm environment: Provide a calm environment.

C Continuous supervision: Never leave the child alone.
A Avoid restraints: Don’t restrain the child.
R Restrict oral intake: Keep the child nothing by mouth.
E Ease anxiety: Keep the child calm to prevent airway obstruction.

Epiglottitis NCLEX Mastery Guide

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ABG Analysis

ABG Analysis

Mastering ABG analysis is essential for nursing practice and success on the NCLEX. Each question in this set emphasizes key concepts, including the identification of acid-base imbalances, physiological responses, and their implications for patient care. A strong grasp of these principles will enhance your ability to assess and respond effectively to patients' needs in various clinical situations.

The number of attempts remaining is 5

1 / 50

The nurse is caring for a patient with COPD. Which ABG result would indicate respiratory acidosis?

2 / 50

A patient with a history of excessive alcohol consumption presents with ABG results: pH 7.30, PaCO2 40 mmHg, HCO3- 15 mEq/L. What is the likely diagnosis?

3 / 50

What is a common cause of metabolic acidosis?

4 / 50

A nurse notices a patient has rapid, shallow breathing. The patient’s ABG shows: pH 7.45, PaCO2 30 mmHg, HCO3- 22 mEq/L. What is the likely diagnosis?

5 / 50

A patient presents with confusion and lethargy. ABG analysis reveals pH 7.34, PaCO2 55 mmHg, HCO3- 26 mEq/L. Which of the following interventions is the priority?

6 / 50

In which condition would you expect to see a decreased HCO3- level?

7 / 50

A patient has a pH of 7.30, PaCO2 30 mmHg, HCO3- 18 mEq/L. What is the most likely diagnosis?

8 / 50

A patient presents with confusion and fatigue. Their ABG results show: pH 7.28, PaCO2 58 mmHg, HCO3- 22 mEq/L. What condition do these findings suggest?

9 / 50

A patient presents with tachycardia and muscle cramps. ABG analysis shows: pH 7.50, PaCO2 38 mmHg, HCO3- 30 mEq/L. What should the nurse assess for?

10 / 50

If a patient is experiencing metabolic acidosis, what would you expect the respiratory compensation to be?

11 / 50

A patient is hyperventilating due to anxiety. What would you expect their ABG results to show?

12 / 50

In a patient with respiratory acidosis, what is the expected change in the kidneys?

13 / 50

A patient with renal failure shows ABG results of pH 7.25, PaCO2 40 mmHg, HCO3- 16 mEq/L. This indicates:

14 / 50

A patient with diabetic ketoacidosis has the following ABG results: pH 7.25, PaCO2 30 mmHg, HCO3- 15 mEq/L. What is the primary acid-base imbalance?

15 / 50

A patient with chronic kidney disease shows signs of acidosis. What ABG change would be expected?

16 / 50

A patient presents with tachypnea and lightheadedness. Which ABG finding would be expected?

17 / 50

A patient with diabetes presents with a fruity odor on their breath. ABG results show: pH 7.25, PaCO2 40 mmHg, HCO3- 15 mEq/L. What condition is this indicative of?

18 / 50

A patient’s ABG indicates a pH of 7.50, what should the nurse suspect?

19 / 50

Which of the following ABG values would indicate respiratory alkalosis?

20 / 50

A patient with chronic respiratory acidosis may develop:

21 / 50

A patient with a history of COPD is experiencing respiratory acidosis. Which intervention is most appropriate?

22 / 50

Which of the following ABG results would indicate metabolic acidosis?

23 / 50

If a patient’s ABG shows a pH of 7.28, what should the nurse suspect?

24 / 50

A patient has the following ABG results: pH 7.30, PaCO2 50 mmHg, HCO3- 24 mEq/L. What is the primary acid-base disturbance?

25 / 50

The nurse is interpreting ABG results: pH 7.50, PaCO2 30 mmHg, HCO3- 24 mEq/L. What condition is indicated?

26 / 50

Which patient condition would most likely cause metabolic alkalosis?

27 / 50

A patient with chronic kidney disease has a pH of 7.35 and HCO3- of 18 mEq/L. What is the likely diagnosis?

28 / 50

A patient with severe dehydration would likely exhibit which of the following ABG results?

29 / 50

ABG results show: pH 7.47, PaCO2 38 mmHg, HCO3- 29 mEq/L. The nurse should assess for which of the following?

30 / 50

A nurse is reviewing ABG results: pH 7.35, PaCO2 50 mmHg, HCO3- 25 mEq/L. Which condition is most likely?

31 / 50

A nurse is assessing a patient with potential metabolic acidosis. Which sign would be most indicative?

32 / 50

In a patient with a suspected pulmonary embolism, what ABG changes might you expect?

33 / 50

ABG results show: pH 7.45, PaCO2 35 mmHg, HCO3- 21 mEq/L. What is the interpretation?

34 / 50

ABG results show: pH 7.48, PaCO2 42 mmHg, HCO3- 30 mEq/L. What does this indicate?

35 / 50

If a patient is experiencing metabolic alkalosis, which ABG result might be expected?

36 / 50

A patient is hypoventilating after a drug overdose. What would their ABG likely show?

37 / 50

A patient is experiencing respiratory distress and has an ABG result of pH 7.32, PaCO2 52 mmHg, HCO3- 24 mEq/L. What does this indicate?

38 / 50

A patient with an acute asthma attack is likely to have which of the following ABG results?

39 / 50

A patient with renal failure presents with ABG results: pH 7.32, PaCO2 42 mmHg, HCO3- 16 mEq/L. What does this indicate?

40 / 50

A patient presents with a high HCO3- level and a pH of 7.50. What could this indicate?

41 / 50

A patient’s ABG shows: pH 7.45, PaCO2 48 mmHg, HCO3- 36 mEq/L. What condition does this most likely indicate?

42 / 50

A patient in renal failure presents with pH 7.30 and HCO3- 15 mEq/L. What is the expected respiratory response?

43 / 50

ABG results show: pH 7.40, PaCO2 32 mmHg, HCO3- 19 mEq/L. Which acid-base balance does this indicate?

44 / 50

Which of the following can lead to metabolic alkalosis?

45 / 50

ABG results show: pH 7.38, PaCO2 48 mmHg, HCO3- 26 mEq/L. This indicates which type of compensation?

46 / 50

A patient has a pH of 7.39, PaCO2 of 52 mmHg, and HCO3- of 28 mEq/L. This patient is likely experiencing:

47 / 50

Which of the following scenarios would likely lead to respiratory alkalosis?

48 / 50

A patient has a pH of 7.39, PaCO2 of 52 mmHg, and HCO3- of 28 mEq/L. This patient is likely experiencing:

49 / 50

A nurse reviews an ABG report: pH 7.35, PaCO2 55 mmHg, HCO3- 22 mEq/L. Which nursing diagnosis is appropriate?

50 / 50

What is the normal range for arterial blood pH?

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