Pharyngitis and Tonsillitis
Co-morbidities due to infection.
Inflammation of throat.
If throat is primarily affected; pharyngitis
If mainly tonsils (lymphoid tissue affected; located in oropharynx.
If both throat and tonsils affected and inflamed; pharyngotonsillitis.
Etiology
1. Viruses;
Adenovirus
Influenza viruses
epstein-barr virus
Herpes simplex Virus
2. Bacteria
Group A hemolytic streptococci
Neisseria gonorrhoea
Haemophilus influenza
Chlamydia pneumonia
3. Fungi
Candida species
4. Parasitic infection
Clinical features
1. Sore throat
2. Fever
3. Headache
4. Anorexia
5. Malaise
6. Dysphagia (painful swallowing)
7. Muscle aches
Diagnostic Evaluation
1. Child history taking and physical examination
2. Complete blood count (CBC)
3. Throat culture
4. Antibiotic sensitivity
Management
Surgical procedure to remove tonsils called dissection.
1. Warm saline gurgles
2. Throat lozenges
3. Antibiotic (if bacterial infection)
4. Antipyretics and non- aspirin analgesics
Surgical Management
1. Tonsillectomy with or without adenoidectomy
Nursing Management
1. Preoperative Nursing Care
Evaluate child for severity of condition.
Check and record result, lab investigation including bleeding and clotting time.
1. Make preoperative assessment
2. Prepare child for surgery
3. Explain need of surgery (tonsillectomy)
4. Tell child to talk in soft voice after surgery and have sore throat post operatively.
2. Post operative nursing care
1. Watch and control hemorrhage
Record vital sign frequently (1-2 hours)
Observed increase pulse rate, pallor, bleeding from nose and mouth, frequent swallowing and clearing of throat.
2. Maintain airway
Observed sign of stridor, cyanosis, rapid respiration, suction the secretion.
3. Control fever
Monitor temperature (every 2 hours)
Encourage intake oral fluids
Antipyretic medication
4. Promote adequate hydration
Maintain IV fluids.
Start oral fluids when no vomiting.
5. Relieve anxiety of child and parents
Explain chid have sore throat for 1-2 weeks.
Temporary changes in voice
Ear pain mainly on swallowing
White patches around wound area.
Reassure child and parents that minute blood in mucous or coffee colour of vomitus are normal.
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