Croup
SITUATION:You are working as a pediatric RCP in a large, 800-bedtertiary medical center and are assigned to the pediatric ED foryour 12-hour shift. At approximately 0900, Jacob, a 3-year-old boy,presents to the ED with difficulty breathing. He has had a feverand runny nose for the past two days. Overnight he has hadworsening respiratory distress and now has inspiratory stridor atrest.
1. What is your priority assessment (give rationale)?
The following data is obtained during your assessment Jacob isalert, with stridor at restHe is not droolingRespiratory rate: 60breaths per minuteSpO2: 92% in room airHeart rate: 140 beats perminuteTemperature: 102.6 His oropharyngeal is normal. His chestfindings reveals mild intercostal and supraclavicular retractionswith decreased air exchange. He is noted to have some cyanosis withagitation. The remainder is unremarkable.
2. What is your interpretation of this information? Create aSOAP for this client.SOAP
3. What do you suspect as Jacob’s primary diagnosis? Why?
4. Recommend treatment for Jacob. What is the rationale behindyour recommendation?
5. You are calling the physician to obtain orders for treatment.Write out the SBARreport:SituationBackgroundAssessmentRecommendation
6. Is Jacob ready to be discharged home? Why or why not?
7. Describe the pathophysiology of bacterial and viral croup.Explain common findings.
8. Based on current evidence, what is the most appropriatetreatment for croup?
