Ward Class

An Online Resource Site For Student Nurses


Ward Class is an online resource for student nurses. Created with the aim of helping student nurses cope with the demands of nursing school and clinicals, it offers free downloads, notes, sample NCPs, sample drug studies, study aids, news and updates, and practical tips to its users.

Site Announcement

The December 2012 PRC Nursing Board Exam Result is already available here at Ward Class and at Pinoy R.N.

Respiratory Disorders: Croup

  • also called Acute Spasmodic Laryngitis
  • a respiratory distress without cyanosis characterized by sudden attacks of laryngeal obstruction, usually at night
  • common among children under the age of 5, esp. ages 1-3 y.o.
  • usually preceded by a mild respiratory infection
  • Causes include: family history, allergy, viral infections (parainfluenza virus), bacterial infections (rare), and psychologic factors
Assessment Findings
  • seal-bark cough-->classic sign; bursts of very harsh, loud nighttime cough
  • inspiratory stridor
  • subglottic swelling
  • Marked retractions
  • cool skin
    • note: all symptoms usually subside in hours with home treatment of moist air
Medical Management
  1. corticosteroids and/or epinephrine (via nebulizer)--> reduces inflammation and promotes brochodilation; for worsening symptoms
  2. antibiotics-->if bacterial infection is present
  3. humidified oxygen tent-->breathing moist air relieves symptoms
Nursing Management
  1. monitor vital signs, and observe for extreme air hunger
  2. administer medications as ordered
  3. provide cool mist with vaporizer as soon as the spasm subsides
  4. provide clear fluids
  5. maintain a calm and quiet environment-->reduce child's anxiety
  6. instruct parents on home management for croup
    • take child to bathroom, close the door, turn on hot shower, and sit on steamy bathroom floor while holding child closely
  7. emphasize the importance of taking the child to the emergency department as the danger of severe respiratory obstruction is very real
  8. assure parents that symptoms usually resolves in a few hours-->croup is frightening for both child and parents

Most cases of croup are mild. If managed appropriately, complications rarely occur.


Croup is prevented by protecting the child from infections. Handwashing is the most important important preventive measure. Keeping immunizations current will also protect a child from croup.

Note: Some books on Maternal and Child Nursing refer to Croup (acute spasmodic laryngitis) and laryngotracheobronchitis interchangeably. For the purpose of discussion, Ward Class will treat Croup and Laryngotracheobronchitis as two distinct pediatric disorders.


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