Maintaining Fluid Balance. Thchypnea causes insensible water loss, and difficulty swallowing leads to decreased intake. Therefore, the nurse monitors the child’s hydration status with intake and output and urine specific gravity measurements. Check mucous membranes, skin turgor, and presence of tears. Weigh the child daily on the same scale and at the same time of day. Offer the child clear, room temperature liquids as tolerated when the child no longer exhibits signs of respiratory distress. Observe the child’s ability to swallow because tachypnea and laryngospasm often cause dysphagia. IV fluids are administered in the acute phase of croup because oral fluids are contraindicated in the setting of severe respiratory distress that heightens the risk for aspiration. The child’s temperature is monitored every 4 hours, and acetaminophen is administered as ordered.