Clinical quiz: Managing croup in primary care

Croup is one of the most common respiratory illnesses seen in young children, typically caused by viral infections. Although many cases are mild and self-limiting, croup can be severe and even life-threatening, so timely assessment is vital.

Nurses in primary care are often the first to be consulted when an infant has croup symptoms, so it is vital they feel confident in recognising the characteristic features and assessing severity to ensure children receive the right care at the right time.

This quiz will help you refresh your understanding of croup, from identifying key symptoms to applying evidence-based management strategies.

Work your way through the cases and questions to test your knowledge.

Click start below to begin the quiz.

<section data-block="MultipleChoice"> <h3>You are seeing a 2-year-old girl who has a cough and noisy breathing which her mother is worried about. The girl’s older sister had a nasty bout of croup a few years ago and this is her mother’s main concern. Which of the following facets to a presentation would make you suspect croup? Select all that apply</h3> <ul> <li>Symptoms are worse during the day and improve at night.</li> <li>The cough has a barking character to it.</li> <li>The child is aged under 3.</li> <li>The cough comes alone, with no runny nose, fever or other cold symptoms.</li> </ul> </section> <section data-block="SingleChoice"> <h3>Which of the following is correct about your assessment of the child?</h3> <ul> <li>Examining the throat is essential.</li> <li>Noisy breathing, most prominent during inspiration, would increase your suspicion of croup.</li> <li>The likelihood of croup is increased if her temperature is above 39°C.</li> <li>Focal crackles on chest examination would increase your suspicion she has croup.</li> </ul> </section> <section data-block="MultipleChoice"> <h3>You are aware it is important to assess for the severity of croup – which of the following parameters are part of this? Select all that apply</h3> <ul> <li>Respiratory rate.</li> <li>Pulse rate.</li> <li>Cyanosis.</li> <li>Degree of inspiratory stridor.</li> </ul> </section> <section data-block="SingleChoice"> <h3>The girl’s mother gives a very typical history of croup – she has a barking cough, which is worse at night and started after a few days of a runny nose. She has had a temperature between 37° and 38°C at home but is eating and drinking fine. Her voice is a little hoarse. Her mother knows what stridor sounds like and says that she has heard it when the child is running around but not at other times – you cannot hear it now. She is alert and chatty, with no recession, normal air entry and no cyanosis. Her pulse and respiratory rate are normal, and her temperature is 37.8°C. You judge that she has mild croup, with a Westley score of one for stridor when active.How do you manage her?</h3> <ul> <li>Reassure the mother that croup is caused by a self-limiting viral illness; no treatment is needed.</li> <li>Give a one-off dose of oral dexamethasone.</li> <li>Give antibiotics, to guard against secondary bacterial infection.</li> <li>Treat with the same antivirals that you might use for influenza.</li> </ul> </section> <section data-block="MultipleChoice"> <h3>The mother is reassured by your thorough assessment but wonders how long it will take for her daughter to get better. What do you tell her? Select all that apply</h3> <ul> <li>She might see improvement very quickly – within the hour or within a few hours.</li> <li>It will take 24 – 48 hours to resolve.</li> <li>The bad cough and stridor will improve quickly with the dexamethasone, but she may have a milder cough for a few weeks.</li> <li>It usually takes 3 months for the cough of croup to properly go.</li> </ul> </section> <p>  <p>  <p>  <p>  <p>

Note all cases in this series are hypothetical and developed for educational purposes

Clinical quiz: Managing croup in primary care

Related articles

Most Popular