Care of tonsilitis patient

BY : SRN NOORHAZAMINNURSING EDUCATION SERVICES

At the end of this session, you will be able to :State the definition of tonsilitis.

List the etiology of tonsilitis.Identify the pathophysiology of tonsilitis.

State the sign & symptom of tonsilitis.

LEARNING OBJECTIVES cont.Identify the complication of tonsilitis.

Identify the nursing intervention & appreciate the nursing care for tonsilitis patient.

PATIENT’S PROFILE MISS. A

FEMALE

23 YEARS OLD

STUDENT

PATIENT’S PROFILE WALKED IN

CALM

ALLERGICS - NIL

D.O.A 3/5/12 @ 1040H

Doctor = Dr F

Diagnosis = RECURRENT TONSILITIS

PATIENT’S PROFILE MEDICAL HISTORY Tonsilitis & rhinitis since Nov 2011

SURGICAL HISTORY Nil

FAMILY MED HISTORY Sinusitis (father)

CURRENT MEDICATION

Efurox 1 BD

Aerius 5mg Nocte

VITAL SIGN TEMPERATURE : 36.0˚C BLOOD PRESSURE :120/70mmHg

PULSE : 80 bpm RESPIRATION : 21 bpm PAIN SCORE : 5

ACTIVITY DAILY LIVING

Having difficulty in swallowing and pain during swallowing

Loss of appetite

Anxious and asking many questions.

PHYSICAL EXAMINATION

S/B Dr F in clinicSurgical Profile NBM For tonsilectomy

Tonsils are large lymphoid tissue situated in the lateral wall of the oropharynx.

They form lateral part of the Waldeyer's ring.

Tonsil occupies the tonsillar fossa between diverging palato-pharyngeal and palatoglossal folds

Tonsil has two surfaces, medial and lateral; two borders anterior and posterior; two poles upper and lower; two developmental folds plica triangulris and plica semilumris; and one cleft intratonsillar cleft.

Medial surface is covered by squamous epithelium and presents 15-20 crypts usually plugged with epithelial and bacterial debris

Lateral surface extends deep to surrounding boundaries. It is coated with a fibrous sheet, an extension of pharyngobasilar fascia called capsule of the tonsil.

The capsule is loosely attached to the muscular wall but antero-inferiorly it is attached firmly to the side of the tongue just in front of insertion of palatoglossus and palatopharyngeus muscles

Chronic tonsilitis Peritonsillar abcess Para pharyngeal abcess Otitis media Rheumatic Fever Laryngeal oedema Septicaemia

Haemoglobin 11.3g/dL (11.5-16.0)

Sodium 134mmol/L (135-155)

DRUGSORDERED ON PRE MED

DATEORDERED

Tab Zantac 150 mg STAT 3/5/12

Tab Maxalon 10 mg STAT 3/5/12

Tab Celebrex 200 mg STAT 3/5/12

DRUGSPOST OPERATIVE

DATEORDERED

DATE OFF

IV Zinacef 750mg TDS 3/5/12 5/5/12

IV Dynastat 40mg BD 3/5/12 5/5/12

IM Pethidine 50mg 8H PRN 3/5/12 5/5/12

Danzen 1/1 TDS 3/5/12 5/5/12

Difflam Lozenges 1/1 TDS 3/5/12 5/5/12

PCM 11/11 PRN TDS 3/5/12 5/5/12

Alteration in comfort pain related to sorethroat.

NURSING DIAGNOSIS

Alteration in emotional status anxiety related to surgical procedure.

NURSING DIAGNOSIS

NURSING DIAGNOSIS Potential bleeding related to surgical wound.

NURSING DIAGNOSISPotential infection related to surgical incision.

NURSING DIAGNOSIS Potential infection related to intravenous cannula insertion.

NURSING DIAGNOSIS Knowledge deficit related to treatment regime and post operative hygeine care.