Primary Nursing Diagnosis

Ineffective airway clearance related to tracheobronchial infection and obstruction

OUTCOMES. Respiratory status: Airway patency; Respiratory status: Gas exchange; Respiratory status: Ventilation

INTERVENTIONS. Airway management; Respiratory monitoring; Vital signs monitoring; Anxiety reduction

H PLANNING AND IMPLEMENTATION Collaborative

The aim of treatment is to maintain a patent airway and provide adequate repiratory exchange. Medical management includes bronchodilating medications, cool mist in a croup tent during sleep, and intravenous hydration if oral intake is inadequate. Oxygen may be used, but it masks cyanosis, which signals impending airway obstruction. Sedation is contraindicated because it may depress respirations or mask restlessness, which indicate a worsening condition. Sponge baths may be needed to control temperatures above 102°F. You may need to isolate the child if the physician suspects syncytial virus or parainfluenza infections.

Laryngoscopy may be necessary if complete airway obstruction is imminent. A flexible nasopharyngoscopy can be used; an intubation or a tracheostomy is performed only if no other method of airway maintenance is available. Keep intubation and tracheostomy trays near the bedside at all times, for use in case of emergencies.

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