Croup: NCLEX Priorities
Croup: barky cough, stridor, racemic epinephrine, dexamethasone.
Croup is laryngotracheobronchitis. NCLEX tests the barky cough and management.
Recognition
Barky/seal-like cough, inspiratory stridor, hoarseness. Worse at night. Often after URI. Toddlers 6 months-3 years.
Severity
Mild: stridor with agitation only. Moderate: stridor at rest. Severe: increased work of breathing, retractions, hypoxia.
Treatment
Dexamethasone single dose (oral, IM, or IV), first-line. Racemic epinephrine nebulizer for moderate-severe stridor at rest. Cool mist therapy controversial but commonly tried.
Monitor 3-4h after epi
Rebound stridor possible. Observe.
Frequently asked
Croup vs epiglottitis?
Croup: gradual, barky cough, low fever, child can lie down. Epiglottitis: rapid, drooling, tripod position, sick-appearing, high fever. Don't examine throat, emergency intubation setup.
Home management?
Mild croup: humidified air, fluids. Return for stridor at rest.
Quick check
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