Definition of Croup – Health of the children has been considered as the vital importance to all societies because children are the basic resource for the future of humankind. Nursing care of children is concerned for both the health of the children and for the illnesses that affect their growth and development. The increasing complexity of medical and nursing science has created a need for special area of child care, i.e. pediatric nursing.
Pediatric nursing is the specialized area of nursing practice concerning the care of children during wellness and illness. It includes preventive, promotive, curative and rehabilitative care of children. It emphasizes on all round development of body, mind and spirit of the growing individual. Thus, pediatric nursing involves in giving assistance, care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity.
Definition of Croup
Croup is a common, primarily pediatric viral respiratory tract illness. As its alternative names, acute laryngotracheitis and acute laryngotracheobronchitis, indicate, croup generally affects the larynx and trachea, although this illness may also extend to the bronchi. This respiratory illness, recognized by physicians for centuries, derives its name from an Anglo-Saxon word, kropan, or from an old Scottish word, roup, meaning to cry out in a hoarse voice.
Croup is the most common etiology for hoarseness, cough, and onset of acute stridor in febrile children. Symptoms of coryza may be absent, mild, or marked. The vast majority of children with croup recover without consequences or sequelae; however, it can be life-threatening in young infants.
Croup manifests as hoarseness, a seal-like barking cough, inspiratory stridor, and a variable degree of respiratory distress. However, morbidity is secondary to narrowing of the larynx and trachea below the level of the glottis (subglottic region), causing the characteristic audible inspiratory stridor.
Definition of Croup:
Croup refers to inflammation of the larynx characterized by croaking cough, stridor, hoarseness, cold and fever.
Or
Croup, also known as laryngotracheobronchitis, is a type of respiratory infection that is usually caused by a virus. The infection leads to swelling inside the trachea, which interferes with normal breathing and produces the classic symptoms of “barking” cough, stridor, and a hoarse voice
(Ref: Paediatric Nursing, Parul Datta/3rd/418)
Causes of Croup:
Croup is most often caused by viruses such as para-influenza RSV, measles, adenovirus, and influenza. It tends to appear in children between 3 months and 5 years old, but it can happen at any age. Some children are more likely to get croup and may get it several times. It is most common between October and March, but can occur at any time of the year. More severe cases of croup may be caused by bacteria. This condition is called bacterial tracheitis.
Croup may also be caused by:
- Allergies
- Breathing in something that irritates your airway
- Acid reflux
Clinical Feature of Croup:
Symptoms that are common in most cases of croup include:
- Cold symptoms like sneezing and runny nose
- Fever
- Barking cough
- Heavy breathing
- Hoarse voice
Immediate medical attention is required if croup threatens your child’s ability to breath. Contact your doctor as soon as possible if you notice symptoms like:
- High-pitched sounds when breathing
- Difficulty swallowing
- Blue or gray skin coloring around the nose, mouth, and fingernails
Management of Croup:
- Medical Management of Croup:Oxygen therapy
- Antibiotics, (ampicillin, chloramphenicol, ceftriaxone)
- Humidification of environment
- Racemic epinephrine (0.5 mL of 2 percent solution diluted with sterile water to a total volume of 3.5 m) through nebulizer.
- Single dose of dexamethasone (0.6 mg/Kg) IM, reduces severity of the condition.
- Inhalation of budesonide in doses of 1 to 2 mg gives significant effect.
- Nasotracheal intubation or tracheostomy maybe indicated in cases of severe obstruction.
(Ref: Paediatric Nursing, Parul Datta/3rd/418)
Supportive Nursing Care:
- Maintenance of upright position
- Rest
- Oxygen therapy
- Humidified environment
- Monitoring of vital signs, respiratory status, pulse oximetry ABG analysis
- Nebulization of racemic epinephrine
- Intravenous fluid therapy
- Administration of medication and hygienic measures.
- Special care to be provided in case of tracheal intubation or tracheostomy.
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