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TONSILLITIS AND ADENOIDITIS tonsillitis (CLINICAL MANIFESTATIONS…
TONSILLITIS AND ADENOIDITIS
DEFINITION
Bacterial infection of the tonsils and adenoids.
PATHOPHYSIOLOGY
Tissue is susceptible to acute and chronic infection.
Once infectious it becomes hypertrophied.
Lymphoid tissue normally enlarges during childhood.
Normal breathing patterns are altered.
This ring consists of:
Factual lymphoid tonsils.
Pharyngeal lymphoid tissue known as adenoids.
Lingual tonsils.
This forms protective barrier against upper respiratory infection.
Ring of lymphoid tissue encircles the pharynx.
CAUSES
Immunologic mechanisms
Frequent exposure to germs.
Anaerobic bacteria
Epstein-Barr virus
CLINICAL MANIFESTATIONS
Obstructive sleep apnea.
Fever above 38.4 degrees Celsius.
Obstructed upper airway.
Sore throat
Hypertrophied tonsils.
Dysphagia
Scratchy , muffled voice.
Stiff neck.
NURSING DIAGNOSIS
Deficient fluid volume.
Acute pain.
Risk of aspiration.
NURSING MANAGEMENT
Prevention of aspiration
Suctioning all oral secretions.
Discourage coughing.
Encourage prone position with head turned to one side.
Head must be kept slightly lower than chest.
Relieving pain
Administer prescribed analgesia.
Provide soothing reassurance.
Apply ice cooler postoperatively.
Discourage crying irritating throat.
Maintaining fluid and electrolyte balance.
Discourage irritating fluids eg orange juice blend.
Monitor fluid intake and output daily.
Encourage fluid intake postoperatively.
COLLABORATIVE MANAGEMENT
Insertion of CVP for enteral feeding.
Placing nasal airway device for obstructed airway.
Improving hydration status of patient.
Administering humidified oxygen.
Tonsillectomy with repeated exposure.
Adenoidectomy for inflamed adenoids.
PHARMACOLOGICAL THERAPY
Intravenous infusion maintaining hydration status.
Intravenous antibiotics for infection.
Penicillin
Intravenous corticosteroids providing anti-inflammatory effect..
Analgesia for pain.
Ibuprofen
Acetaminophen
Immunologic agents reducing severity of infection.
Gamma globulin
DIAGNOSTIC TESTS
Physical examination inclusive of:
Checking for rash known as scarlatina.
Gentle palpation of the neck.
Direct observation of tonsils and adenoids.
Listening to breathing sounds with stethoscope.
Throat swab checked for streptococcal bacteria.
Complete blood cell count.
