A 5-year-old with croup and mild respiratory distress; which nursing intervention should the nurse prepare?

• A. Respiratory treatment of racemic epinephrine
• B. Immediate IV placement
• C. A tracheostomy set at bedside
• D. Informing the child's parents about a tonsillectomy

Answer: (A)

In croup, relieving subglottic airway edema quickly is the key. Racemic epinephrine given by nebulization provides rapid alpha-adrenergic–mediated vasoconstriction that reduces swelling in the airway, which lowers resistance and improves stridor and breathing within minutes. For a child with mild respiratory distress, preparing this respiratory treatment allows for prompt relief if edema worsens and buys time for additional therapies like corticosteroids (e.g., dexamethasone) and close observation. Because the effect is temporary—typically about 1–2 hours—the child needs monitoring after administration to watch for rebound symptoms and ensure safe observation, usually with pulse oximetry and readiness to intervene if breathing worsens.

The other options aren’t aligned with the current needs: immediate IV placement isn’t routinely required for mild croup, a tracheostomy set isn’t indicated for this level of distress, and discussing tonsillectomy isn’t relevant to acute croup management.