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Tonsillitis and Adenoiditis Tonsillitis and Adenoiditis

Tonsillitis and Adenoiditis - PowerPoint Presentation

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Uploaded On 2016-03-29

Tonsillitis and Adenoiditis - PPT Presentation

Islamic University Nursing College Tonsillitis Inflammation of tonsils Masses of lymphoid tissue in pairs Often occurs with pharyngitis Characterized by fever dysphagia or respiratory problems forcing breathing to take place through nose ID: 271289

bleeding blood throat child blood bleeding child throat nurse airway monitor mouth bacterial alert tonsillitis respiratory swallowing tonsils nursing

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Presentation Transcript

Slide1

Tonsillitis and Adenoiditis

Islamic University

Nursing College Slide2

Tonsillitis

Inflammation of tonsils.

Masses of lymphoid tissue in pairs

Often occurs with

pharyngitis

Characterized by fever,

dysphagia

, or respiratory problems forcing breathing to take place through noseSlide3

Nurse Alert!

Key to understanding

prevention of URI is

careful hand-washing

and avoiding exposure

to infected

persons.Slide4

Nurse Alert!

The nurse should remind the child with a positive throat culture for strep to discard their toothbrush and replace it with a new one after they have been taking antibiotics for 24 hoursSlide5

Causes

Viral.

Bacterial ( group A beta hemolytic streptococci (GABHS).Slide6

Clinical Manifestations

Tonsillitis

Fever

Persistent or recurrent sore throat

Anorexia

General malaise

Difficulty in swallowing, mouth breather, foul odor breath

Enlarged tonsils, bright red, covered with

exudate

Adenoiditis

Stertorous

breathing - snoring, nasal quality speech

Pain in ear, recurring

otitis

mediaSlide7

Surgical treatment Tonsillectomy. If recurrent.

Not recommended before 3 years of age due to:

Excessive blood loss.

Tonsils grow back.Slide8

Nursing Care for the Tonsillectomy and Adenoidectomy Patient

Why is collection of blood for assessment of bleeding and clotting times so important? Slide9

Post-operative Care

Providing comfort and minimizing activities or interventions that precipitate bleeding

Place on abdomen or side until fully awake

Manage airway

Monitor bleeding, esp. new bleeding

Ice collar, pain meds

Avoiding fluids until fully awake --then liquids and soft cold foods. Avoid citrus juices, milk

Do not use straws or put tongue blade in mouth, no smoking (in teenagers). Slide10

Nurse Alert for Post-Op T/A surgery

Most obvious sign of early bleeding

is the child’s continuous

swallowing of trickling blood.

Note the frequency of

swallowing and notify

the surgeon immediatelySlide11

Epiglottitis

Bacterial

form of croup (H influenza) with unique symptoms and treatment

Bacterial infection invades tissues surrounding the epiglottis

Epiglottis becomes edematous, cherry red and may completed obstruct airway

Progresses rapidly, child is unable to swallow, droolingSlide12

Cardinal signs and symptoms

May have had mild URI few days prior

Drooling

Dysphasia

Dysphonia

Distressed respiratory efforts

Tripod position: supported by arms, chin thrust out, mouth openSlide13

ER Management

NEVER leave child unattended

Don’t examine or culture throat or start IV/Blood samples

Patent airway ASAP

Monitor oxygenation status, (continuous pulse ox, humidified O2)

Antipyretics suppository

Calm the parent! Explain what is going on…a calm parent=calmer child!

OR- intubation

Throat & blood cultures done after intubation

Usually

extubated

after 48h

Antibiotics for 7-10 days

Discharge Slide14

Nursing Interventions on unit once stable

Continually assess for s/s of respiratory distress

Maintain pulse ox above 95% with PaO2 between 80-100mmHg

Maintain patent airway

Position for comfort (never force to lie down)

Relieve anxiety

Monitor temp (antipyretics, ABX)Slide15

Thank you