Nursing management of the patient with Tonsillitis PPT

Prepared by Prof. Blessy Thomas MSc Nursing, FNCON, SPN. The tonsils are two small glands that sit on either side of the throat.
In young children, they help to fight germs and act as a barrier against infection.
 Tonsils act as filters, trapping germs that could otherwise enter the airways and cause infection.
They also make antibodies to fight infection.
But sometimes, they get overwhelmed by bacteria or viruses.
This can make them swollen and inflamed.
Tonsillitis is an infection of the tonsils, two masses of tissue at the back of the throat.
Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.

Tonsillitis is common, especially in children.
It can happen once in a while or come back again and again in a short period.Nursing management of Tonsillitis is important.
A comprehensive understanding of the operations for management of Tonsillitis and areas requiring special attention would be important.

1. TOPIC- TONSILLITIS Prepared by :- Prof. BLESSY THOMAS, MSc NURSING, FNCON,SPN

2. INTRODUCTION The tonsils are two small glands that sit on either side of the throat. In young children, they help to fight germs and act as a barrier against infection.  Tonsils act as filters, trapping germs that could otherwise enter the airways and cause infection. They also make antibodies to fight infection. But sometimes, they get overwhelmed by bacteria or viruses. This can make them swollen and inflamed. Tonsillitis is common, especially in children. It can happen once in a while or come back again and again in a short period.

3. ANATOMY AND PHYSIOLOGY Tonsils Tonsils are large lymphoid tissue situated in the lateral wall of the oropharynx . 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.

4. Cont…… Medial surface is covered by squamous epithelium 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

5. DEFINITION Tonsillitis is an infection of the tonsils, two masses of tissue at the back of the throat. Tonsillitis is inflammation of the tonsils, two oval-shaped pads of tissue at the back of the throat — one tonsil on each side.

6. CAUSES Most cases of tonsillitis are caused by a viral infection, such as the viruses that cause the common cold or flu virus (influenza). staying away from public places, such as work, school or nursery, until your GP says it's safe to return (usually after the symptoms have passed)

7. Cont…….. coughing and sneezing into a tissue and disposing of the tissue  washing hands before eating, after going to the toilet and, if possible, after coughing and sneezing Bacterial infection a common cause is Streptococcus (strep) bacteria, which can also cause strep throat.

8. Other common causes include : Adenoviruses Influenza virus Epstein-Barr virus Parainfluenza viruses Enteroviruses Herpes simplex virus

9. RISK FACTORS Age-affects children than adults 5 to 15 years of age more common in very young children. Elderly adults are at higher risk for tonsillitis too.

10. TYPES Acute tonsillitis .   These symptoms usually last 3 or 4 days but can last up to 2 weeks Tonsillitis is incredibly common in children. Almost every child will probably get tonsillitis at least once. Symptoms last around 10 days or less.

11. Chronic tonsillitis.   sore throat bad breath (halitosis) tender lymph nodes in the neck Chronic tonsillitis may also cause tonsil stones, where materials like dead cells, saliva, and food build up in the tonsils. Eventually, the debris can harden into small stones. These may come loose on their own, or need to removed.

12. Recurrent tonsillitis .   Tonsillitis comes back multiple times during the year, it may be chronic or recurrent tonsillitis As with chronic tonsillitis, a standard treatment for recurrent tonsillitis is a tonsillectomy. Recurrent tonsillitis is often defined as: A sore throat or tonsillitis at least 5 to 7 times in 1 year Occurrences of at least 5 times in each of the previous 2 years Occurrences of at least 3 times in each of the previous 3 years

13. PATHOPHYSIOLOGY Due to etiological factors virus or bacteria enter inside our body through nose or throat Inflammatory response will occur(inflammation & infection ) Red and swollen tonsils Clinical manifestations

14. CLINICAL MANIFESTATIONS inflamed and swollen tonsils, sometimes severe enough to make it hard to breathe through mouth Other symptoms include: Throat pain or tenderness Fever Red tonsils A white or yellow coating on your tonsils Headache Loss of appetite Ear pain Trouble swallowing Swollen glands in your neck or jaw Fever and chills Bad breath A scratchy or muffled voice Stiff neck Painful blisters or ulcers on your throat

15. Tonsillitis Symptoms in Children In children, symptoms may also include: Upset stomach Vomiting Stomach pain Drooling Not wanting to eat or swallow

16. DIAGNOSIS History collection Physical exam- look at tonsils for redness, swelling or pus on them. Check for a fever. Also check the ears and nose for signs of infection and feel the sides of neck for swelling and pain. Throat swab. Testing saliva and cells from the throat for strep bacteria. Run a cotton swab along the back of throat. Results are usually ready in 10 or 15 minutes A blood test.  a complete blood cell count (CBC). It looks for high and low numbers of blood cells to show whether a virus or bacteria caused your tonsillitis.

17. MANAGEMENT PHARMACOLOGICAL MANAGEMENT Antibiotics. One-time injection or in pills that you’ll swallow for several days. Feel better within 2 or 3 days, Get lots of rest Drink warm or very cold fluids to help with throat pain Eat smooth foods, such as flavoured gelatine, ice cream. Use a cool-mist vaporizer or humidifier in the room. Gargle with warm salt water. Suck on lozenges with benzocaine or other medications to numb throat. Take over-the-counter pain relievers such as acetaminophen or ibuprofen

18. SURGICAL MANAGEMENT Tonsillectomy It is the removal of tonsils. Tonsillectomy used to be a very common treatment. It is an outpatient procedure. It usually lasts less than an hour. Recovery usually takes 7 to 10 days. May have some pain in throat, ears, jaw, or neck after the surgery. Get plenty of rest and drink lots of fluids while recovering. But don’t eat or drink any dairy products for the first 24 hours.

19. Tonsillitis Prevention Washing your hands often Not sharing food, drink, utensils, or personal items like toothbrushes with anyone Staying away from someone who has a sore throat or tonsillitis

20. COMPLICATIONS A collection of pus around the tonsil (peritonsillar abscess) Middle ear infection Breathing problems or breathing that stops and starts while sleeping (obstructive sleep apnea ) Tonsillar cellulitis , or infection that spreads and deeply penetrates nearby tissues

21. CONCLUSION Nursing management of Tonsillitis is important. A comprehensive understanding of the operations for management of Tonsillitis and areas requiring special attention would be important .

22. ASSIGNMENT Nursing care plan on tonsillitis  

23. BIBLIOGRAPHY Smeltzer SC, et al. Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 11th edition. Lippincott Williams & Wilkins, 2007. Chintamani and Mrinalini Mani Textbook of Medical-Surgical Nursing, Elsevier India; 3rd edition 2018 Javed Ansari And Davinder Kaur , Concise Course In Medical Surgical Nursing ‎ 1 st edition, vikas and company ( pv ) publication 2017