The nurse is caring for pediatric clients in an acute care setting. Which of these clients should the nurse see first?

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11ecbb05_cbc9_23f4_b433_ef740122bfc8_MD0009_00 Epiglottitis refers to inflammation of the epiglottis that may result in life-threatening airway obstruction. Haemophilus influenzae type b (Hib) was the most common cause, but the incidence has decreased dramatically with widespread Hib vaccination. Symptoms begin with abrupt onset of high-grade fever and a severe sore throat, followed by the 4 Ds: drooling, dysphonia, dysphagia, and distressed airway (inspiratory stridor). Children are typically toxic-appearing and may be "tripoding" (sitting up and leaning forward) with inspiratory stridor. This client should be assessed first due to being unstable from an airway disorder. The client has a respiratory illness and is drooling, which indicates respiratory distress (Option D). (Option A) Purulent drainage is expected in a 1-day post tubal myringotomy client. The drainage shows the procedure was successful. (Option B) A fever of 102 F (38.8 C) and petechiae in a post valve replacement client could indicate endocarditis. This client would need to be seen second, as this is a circulation disorder. (Option C) A murmur is expected in a client with a patent ductus arteriosus. It is best heard at the left infraclavicular area and has a continuous "machinery" quality. Educational objective: The nurse should assess clients with airway disorders first, breathing second, and circulation last. Epiglottitis refers to inflammation of the epiglottis that may result in life-threatening upper airway obstruction.

The Nurse Is Caring for Pediatric Clients in an Acute