The nurse, in the emergency department, is caring for a child who swallowed a small toy. The child has trouble breathing but is conscious and not making any sounds. The nurse should immediately
The nurse, in the emergency department, is caring for a child who swallowed a small toy. The child has trouble breathing but is conscious and not making any sounds. The nurse should immediately
A. instruct the client to cough to clear the airway.
[13%]
B. apply a bag valve mask.
[6%]
C. perform abdominal thrusts.
[74%]
D. perform a blind finger sweep.
[7%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Respiratory
Client Need
Test Plan
Physiological Adaptation
Related Topic
Medical Emergencies
Item Type
Item Type
Application
Explanation
Choice C is correct. Performing abdominal thrusts should be the first action to relieve the obstruction. This action is essential because the child has trouble breathing and is not making any noise after swallowing a toy, which indicates choking. Since this client has an upper airway obstruction, performing a blind finger sweep is not recommended as it may cause the object to propel further down the airway. The nurse should only attempt a finger sweep if the object is visible.
Choice A is incorrect. If the child is coughing after swallowing an object and can talk, the nurse should encourage the child to cough until the object comes out. If the child is coughing, abdominal thrusts should not be done because the cough reflex is more powerful than the abdominal thrusts. However, if the child is short of breath but conscious and still silent (not making noise) after swallowing an object, it indicates airway obstruction. In this case, the client is not making any noises - therefore, the nurse should not instruct them to cough to clear the object. Instead, the nurse should immediately intervene with abdominal thrusts.
Choice B is incorrect. Applying a bag valve mask would not relieve the airway obstruction, and the nurse's initial concern is maintaining airway patency by removing the obstruction.
Choice D is incorrect. The nurse should never perform a blind finger sweep if the object is not visible. This could cause the object to further dislodge in the airway and cause a complete blockade
Learning Objective
In a conscious child that is having trouble breathing but not making noise after swallowing an object, perform immediate abdominal thrusts to help expel the object.
Additional Info
✓ Abdominal thrusts are performed on children one year and older if they are choking.
✓ Manifestations of airway obstruction warranting immediate follow-up include the child in the tripod position, cyanosis, and unable to speak or cough.
✓ Five abdominal thrusts should be performed, and then the child should be reassessed to see if the object has been expelled.
