Facilitating Airway clearance. The nurse monitors the child’s breathing continuously for signs and symptoms of increased respiratory distress (increased respiratory rate, stridor at rest, nasal flaring, retractions, cyanosis, changes in level of consciousness or increased irritability, decreased or adventitious breath sounds, tachypnea). A child with respiratory distress should never be left alone, and the physician should be notified immediately. If epiglottitis is suspected, the physician should be contacted and the throat should not be inspected because this may result in laryngospasm and airway obstruction. The nurse should administer humidified oxygen at the ordered flow rate and mist only if ordered. Monitor vital signs and pulse oximetry readings frequently. There should be emergency intubation equipment (e.g., intubation tray, oxygen, suction, manual resuscitation bag-valve-mask) closely available should the child’s condition change rapidly. Aerosolized racemic epinephrine is often administered to decrease laryngeal edema, and dexamethasone is given as an anti-inflammatory agent. The child should be observed for recurrence of obstruction, which may occur within a few hours after administration of racemic epinephrine.