Ch. 17: Tonsillitis and Tonsillectomy Flashcards Preview

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

Flashcards in Ch. 17: Tonsillitis and Tonsillectomy Deck (33):
1

What are tonsils?

Masses of lymph-type tissue found in pharyngeal area

2

What do tonsils do?

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

3

Where are palatine tonsils located?

Both sides of the oropharynx

4

What are the other tonsils?

Pharyngeal tonsils, also known as the adenoids

5

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

Tonsillectomy

6

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

Adenoidectomy

7

Are tonsils vascular or avascular?

Highly vascular

8

Since tonsils are highly vascular, what does this do?

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

9

What can enlarged tonsils do?

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

10

Acute tonsillitis occurs when the tonsils become ____ & ____

Inflamed and reddened

11

What may be visible on inflamed and reddened tonsils?

Small patches of yellowish pus

12

Can acute tonsillitis become chronic?

Yes

13

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

Rest
Cool fluids
Warm salt-water gargles

14

Why would we give an antipyretic for tonsillitis?

Decrease fever and manage pain

15

What are some antibiotics to give for tonsillitis?

IM penicillin G
Erythromycin
Azithromycin
Cephs
Ampxocillin

16

What is pre op for tonsillectomy?

NPO status

17

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

-Side lying position or on abdomen to facilitate drainage
-Elevate HOB when child is fully awake

18

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

-Evidence of bleeding
-Assess airway and VS
-Monitor difficulty breathing r/t oral secretions, edema and/or bleeding

19

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

-Frequent swallowing
-Clearing the throat
-Restlessness
-Bright red emesis
-Tachycardia
-Pallor

20

Post-op care of tonsillectomy: Comfort measures?

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

21

Post op care of tonsillectomy: What is the diet?

-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

Post op care of tonsillectomy: What should we discourage?

Coughing
Throat clearing
Nose blowing

*discourage all this to protect the surgical site

23

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

Pointed objects

24

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

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

25

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

If bright red bleeding occurs

26

Discharge: When should we instruct parents to contact provider?

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

27

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

Ice cream stick
Straw

28

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

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

29

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

2 weeks

30

When does full recovery usually occur?

14 days

31

What are some complications of tonsillitis/tonsillectomy?

Hemorrhage
Dehydration
Chronic infection

32

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

C

33

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

B