The nurse is discharging a 2-year-old after an emergency department visit for mild viral croup. Which discharge teaching points should be reinforced with the parents? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Options 1, 2, 4, and 5 are appropriate. Stridor at rest, drooling, retractions, cyanosis, increasing fatigue, or difficulty drinking require urgent reassessment. Keeping the child calm and upright can reduce distress because agitation worsens upper-airway obstruction. A responsible adult should remain with the child and watch breathing closely after discharge. Offer frequent fluids and use weight-based antipyretics when indicated. Option 3 is incorrect because over-the-counter cough and cold medicines are not recommended for a 2-year-old and do not treat the upper-airway inflammation of croup. Hot steam is not required and creates a burn risk.
For croup discharge teaching, emphasize calm positioning, close observation, hydration, and clear emergency return precautions. Avoid over-the-counter cough and cold medicines in a 2-year-old, and do not use hot steam because of scald risk.
2-year-old seen in the ED for mild viral croup: barky cough, mild stridor with agitation only, no retractions at rest. Received single-dose oral dexamethasone and was observed for 4 hours before discharge home.
Viral croup (laryngotracheobronchitis) — Parainfluenza-driven upper airway inflammation in children causing barky cough, stridor, and hoarseness.
Dexamethasone (single-dose) — 0.6 mg/kg PO/IM single dose given in the ED; long half-life eliminates need for home redosing in mild cases.
Return precautions — Stridor at rest, drooling, retractions, cyanosis — return to ED immediately as these signal worsening obstruction.