In suspected epiglottitis, which action should be avoided by the nurse?

• A. Do not visualize the throat or perform throat examination; keep the child calm and prepare for airway management.
• B. Visualize the throat to assess swelling.
• C. Administer bronchodilators and attempt throat culture.
• D. Delay airway management until an emergency team arrives.

Answer: (A)

In suspected epiglottitis, protecting the airway is the top priority. Manipulating the throat or easily provoking the gag reflex can trigger severe laryngospasm and sudden airway obstruction because the epiglottis is inflamed and swollen. Therefore, the action to avoid is visualizing the throat or performing throat examination. The nurse should keep the child calm, minimize distress, and prepare for definitive airway management with the emergency team, without attempting throat instrumentation.

Bronchodilators and throat cultures are not helpful or appropriate in this situation, since the issue is a swollen epiglottis rather than bronchospasm or infection that can be diagnosed by throat culture. Delaying airway management until the emergency team arrives is not safe, as epiglottitis can rapidly progress to complete airway obstruction, so preparation for possible airway intervention should occur promptly.