REFERENCES

Bernhofer, E., (October 25,

2011) "Ethics and Pain Management in Hospitalized Patients" OJIN: The Online Journal
of Issues in Nursing Vol. 17 No.
1.

McVernon, J., Trotter, C. L.,

Slack, M. P. E., Ramsay, M. E.
(2004). Trends in Haemophilus
influenzae type B infections in
adults in England and Wales:
surveillance study. BMJ (325)
7467, pp. 655-658.

EPIGLOTTITIS:
WHAT IS IT?

Epiglottitis is a quick-acting bacterial infection that

causes inflammation of the epiglottis and the
tissues surrounding it. It is most frequently caused
by the Haemophilus influenzae B bacterium, but it
can also be caused by S. aureus, S. pneumoniae,
and group A haemophilic streptococci. The bacteria is inhaled, and it will spread from the epiglottis
to the vallecular, arytenoids, and aryepiglottic
folds. This causes inflammation, swelling, and
cellulitis in all of these areas. As the swelling progresses, the opening in the airway becomes increasingly more narrow, and respiratory acidosis
and hypoxia will occur due to the difficulty in passing air through the trachea, and it will become
difficult to rid the respiratory tract of mucus. If left
untreated, this infection can become fatal within
hours.
Epiglottitis is typically found in children aged two
through seven years old, and found in 30 out of
every 100,000 children under five years. Males
are at a higher risk to this infection than females,
and those with a weak immune system or living in
a crowded environment have a greater chance of
contracting it.

Allen, S. (2012). Epiglottitis.

Healthline. Retrieved March
25, 2015.

Kearney, K (2001). Emergency:

Epiglottitis. The American Journal of Nursing (101)8, pp. 3738.

Ladwig, G. B., & Ackley, B. J.

(2013). Mosbys guide to nursing diagnosis (4th ed.). St. Louis, MO: Mosby.

Nursing Times (2006). Acute Epiglottitis. Nursing Times,(102)

13, p. 31.

Repansky, T. M. (1995). Emergency!: Epiglottitis. The American Journal of Nursing, 95(9),

p. 52.

Respiratory Acidosis. 2012.

In Mosby's dictionary of Medicine, Nursing & Health professions. Philadelphia, PA: Elsevier Health Sciences.

FSU Nursing
This brochure is provided for client
education on epiglottitis. This is not
intended to replace medical care or to be
used for self-diagnosis.

FERRIS STATE UNIVERSITY

SCHOOL OF NURSING

EPIGLOTTITIS

CLINIAL
MANIFESTATIONS
CULTURAL
Sudden onset of
a high fever

Difficulty breathing

Severe sore
throat

Drooling, and
muffled voice.

Tripod position
upright with the
mouth open, jaw
thrust forward,
and tongue hanging out to aid with breathing.
Dysphagia
Stridor
Trouble speaking

COMPLICATIONS
With progression of the disease, the airway
can become blocked, and the client can become cyanotic due to lack of oxygen. The lack
of air will lead to hypoxia, and an increased
concentration of carbon dioxide in the blood.
This will cause the pH of the blood to lower,
causing tremor, tachycardia, and eventual
coma and death if left untreated. In caring for
a patient with epiglottitis, one priority focus is
that the patient remains calm. If the patient
were to become agitated, or begin crying, then
they would increase their risk of closing their
airway.

NCLEX

QUESTIONS

If a child is admitted presenting signs of epiglottitis, what would be a priority assessment

for the nurse?
A. Urine output
B. Blood Pressure
C. Heart Rate
D. Bowel sounds

LIFESPAN AND
CONSIDERATIONS

Epiglottitis can be transmitted to anybody, although

due to the introduction of the Hib vaccine, the incidence of epiglottitis has decreased significantly. Children under the age of two months, and those who
live in countries where the vaccine is not distributed
are at the highest risk. Adults and the elderly are at
risk for this as well, though they do not contract it as
frequently. The immunocompromised are also at a
greater risk for contracting this infection. There did
not appear to be any change in risk based upon race
or culture.

NURSING

DIAGNOSIS

Ineffective airway clearance related to epiglottal

edema

Client will maintain a patent airway at all

times, and demonstrate effective coughing
and clear breath sounds by discharge.

Anxiety and fear related to respiratory distress and

hospital visit.

Client will have posture, expressions, gestures, and activity level to reflect decreased
distress by discharge.

Impaired gas exchange related to inflammation of

the airway.

Client will demonstrate improved ventilation

and adequate oxygenation as evidenced by
blood gas levels within normal parameters.

While assessing a four-year-old client, the nurse observes that the client begins to present with stridor,
her voice has become muffled, and she is seated in
the tripod position What should the nurse do first?
A. Examine the childs throat
B. Lay the child down
C. Alert the physician
D. Intubate the child

NURSING

SIGNIFICANCE

Beneficence and nonmalficence are two words upon

which nursing ethics are based. It is the nurses ethical responsibility to do everything that they can in
caring for their client, and that they do no harm to
the client in the process. If the nurse If a nurse denies
care to a client with this, the client will likely not survive, and the nurse will face legal charges, and very
likely lose her license.
If the incidence of this infection were to increase, that
would impact nursing and the world of medicine by
demonstrating that the vaccine has become ineffective. Researchers would need to determine why this
has occurred and attempt to fix the situation. There
would be an increase in demand for nurses if this
were to occur. More clients would be placed in intensive care, so there would need to be more nurses to
closely monitor and provide quality care to them.
Surgeons and physicians can also provide care to patients affected with this. The client will likely require
intubation, which is put in place by the physician. If
the tube cannot be placed, then a tracheotomy may
be required. This intervention would require a surgeon. Anesthesiologists are also able to provide care
for clients with epiglottitis. In the event of an intubation, their expertise may be required to ensure patient compliance with keeping the tube in place.