The nurse observes an 18 month old who has been admitted with a respiratory tract infection (see figure). The nurse should fi rst:

The child is in respiratory distress and is sitting in a position to relieve the airway obstruction; the nurse should provide a humidifi ed environment with a croup tent with cool mist to facilitate breathing and liquefy secretions. The child should remain sitting to facilitate breathing; the nurse should allow the child to determine the most comfortable position. After the child is breathing normally, the nurse can offer fl uids; the physician also may order intravenous fluids. The nurse can call the rapid response team if the respiratory distress is not relieved by using a croup tent or other vital signs changes indicate further distress.