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ATI Pediatrics-MJ > Ch. 17: Tonsillitis and Tonsillectomy > Flashcards

Ch. 17: Tonsillitis and Tonsillectomy Flashcards

1
Q

What are tonsils?

A

Masses of lymph-type tissue found in pharyngeal area

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2
Q

What do tonsils do?

A

Filter pathogenic organisms (viral and bacterial), which helps to protect the resp and GIT tracts; they also contribute to antibody formation

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3
Q

Where are palatine tonsils located?

A

Both sides of the oropharynx

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4
Q

What are the other tonsils?

A

Pharyngeal tonsils, also known as the adenoids

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5
Q

What is the name of the surgery to remove the palatine tonsils?

A

Tonsillectomy

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6
Q

What is the name of the surgery to remove the pharyngeal tonsils (aka the adenoids)?

A

Adenoidectomy

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7
Q

Are tonsils vascular or avascular?

A

Highly vascular

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8
Q

Since tonsils are highly vascular, what does this do?

A

Help them protect against infection because foreign materials, such as viral or bacterial organisms, that enter the body through the mouth

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9
Q

What can enlarged tonsils do?

A
  • Can block nose and throat (interfers with breathing, nasal & sinus drainage, sleeping, swallowing, and speaking)
  • Can disrupt function of eustachian tube (impedes hearing)
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10
Q

Acute tonsillitis occurs when the tonsils become ____ & ____

A

Inflamed and reddened

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11
Q

What may be visible on inflamed and reddened tonsils?

A

Small patches of yellowish pus

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12
Q

Can acute tonsillitis become chronic?

A

Yes

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13
Q

Nursing care: What does it mean to provide symptomatic care for viral tonsillitis?

A

Rest
Cool fluids
Warm salt-water gargles

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14
Q

Why would we give an antipyretic for tonsillitis?

A

Decrease fever and manage pain

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15
Q

What are some antibiotics to give for tonsillitis?

A 
IM penicillin G
Erythromycin
Azithromycin
Cephs
Ampxocillin
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16
Q

What is pre op for tonsillectomy?

A

NPO status

17
Q

What is the positioning for post-op care of tonsillectomy?

A
  • Side lying position or on abdomen to facilitate drainage

- Elevate HOB when child is fully awake

18
Q

What do we assess for during post op care of tonsillectomy?

A
  • Evidence of bleeding
  • Assess airway and VS
  • Monitor difficulty breathing r/t oral secretions, edema and/or bleeding
19
Q

Post op care of tonsillectomy: One of the things we assess for is evidence of bleeding. What are signs of this?

A
  • Frequent swallowing
  • Clearing the throat
  • Restlessness
  • Bright red emesis
  • Tachycardia
  • Pallor
20
Q

Post-op care of tonsillectomy: Comfort measures?

A
  • Give pain meds at regular schedule
  • Provide ice collar
  • Offer ice chips, sips of water to keep throat moist
  • Give analgesics as prescribed
21
Q

Post op care of tonsillectomy: What is the diet?

A
  • Clear fluids and liquids after a return of gag reflex
  • Avoid red color liquid, citrus juice, and milk based foods initially
  • Advance diet with soft, bland foods
22
Q

Post op care of tonsillectomy: What should we discourage?

A

Coughing
Throat clearing
Nose blowing

*discourage all this to protect the surgical site

23
Q

Post op care of tonsillectomy: Refrain from placing _____ in the back of the throat

A

Pointed objects

24
Q

Post op care of tonsillectomy: During instruction, what should we alert parents about?

A

That there may be clots or blood-tinged mucus in vomit

25
Q

Post op of tonsillectomy: When should we instruct the fam to notify the provider?

A

If bright red bleeding occurs

26
Q

Discharge: When should we instruct parents to contact provider?

A

If child experiences difficulty breathing, lack of oral intake, increase pain, and/or indications of infection

27
Q

Discharge: Make sure the parents own that the child does not need to put anything sharp in the mouth. Examples?

A

Ice cream stick

Straw

28
Q

Discharge: Encourage fluid intake and diet advancement to a soft diet with no _____, or hard/sharp foods like ______ until full recovery

A

No spicy foods or hard/sharp foods like corn chips till full recovery

29
Q

Discharege: Instruct the child and family to limit strenuous activity an physical play with no swimming for ____ as prescribed

A

2 weeks

30
Q

When does full recovery usually occur?

A

14 days

31
Q

What are some complications of tonsillitis/tonsillectomy?

A

Hemorrhage
Dehydration
Chronic infection

32
Q

A nurse is caring for a child who is in the post op period following a tonsillectomy. Which of the following is a clinical finding of post op bleeding?

A. Hgb of 11.6 and Hct of 37%
B. Inflamed and reddened throat
C. Frequent swallowing and clearing of the throat
D. Blood tinged mucus

A

C

33
Q

A nurse is caring for a child in the post op period of a tonsillectomy. Which of the following is an appropriate action for nurse to take?

A. Encourage the child to blow nose gently
B. Administer analgesics on a schedule
C. Offer OJ
D. Position child supine

A

B

ATI Pediatrics-MJ (41 decks)

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