2025-07-25·8 min read·Pediatrics

Pediatric Respiratory Infections: Croup, Epiglottitis, and RSV

Differentiate common pediatric respiratory infections and their nursing management for the NCLEX.

Croup (Laryngotracheobronchitis)

  • Viral (parainfluenza), ages 6 months - 3 years
  • Barky/seal-like cough, stridor, hoarseness
  • Worse at night, gradual onset
  • Treatment: cool mist humidifier, racemic epinephrine, dexamethasone

Epiglottitis

  • Bacterial (H. influenzae), ages 2-8 years
  • Sudden onset, high fever, drooling, tripod position, muffled voice
  • Do NOT inspect throat (risk of laryngospasm)
  • Emergency: intubation equipment at bedside, antibiotics IV

RSV (Respiratory Syncytial Virus)

  • Most common cause of bronchiolitis in infants <2 years
  • Wheezing, tachypnea, nasal flaring, retractions
  • Contact precautions - highly contagious
  • Prevention: palivizumab (Synagis) for high-risk infants

Key Nursing Points

  • Monitor respiratory status closely - young children deteriorate quickly
  • Maintain hydration (small frequent feedings)
  • Avoid throat exams in suspected epiglottitis

Study more at Pediatric Nursing cheat sheet and Health Promotion study guide.