Nursing Care Plan for Tonsillitis and Post Operative Tonsillectomy
Tonsillitis is a common presence of inflammation and swelling of the tonsillar tissue with leucocytes collection, dead epithelial cells and pathogenic bacteria in the crypts (Adam Boeis).
Tonsillectomy is an invasive procedure that is performed to take with or without adenoid tonsil (Adam Boeis).
- Group A ? – hemolytic streptococcus.
- Haemophilus influezae.
- Inflammation in the tonsils caused by a virus.
- Result in the formation of exudate.
- Tonsillar cellulitis occurs and the surrounding area.
- Peritonsillar abscess formation.
- Tissue necrosis.
- Sore throat and dysphagia.
- Patients do not want to eat or drink.
- Breath odor.
- Otitis media is one of the originators factor.
- Bed rest.
- Provision of adequate fluids and light diet.
- Administration of medications (analgesics and antibiotics).
- If there is no progress, then the alternative actions that can be done is surgery.
Indications of Surgery
1. Absolute indication
- The onset of cor pulmonale due to chronic airway obstruction.
- Hypertrophy of tonsils or adenoids with apnea syndrome during sleep.
- Excessive hypertrophy resulting in dysphagia and weight loss as accompanying.
- Excision biopsy in suspected as malignancy (lymphoma).
- Peritonsillar abscess or abscess that extends over and on the surrounding tissue.
2. Relative indications
- The whole other indications for tonsillectomy action is considered as a relative indication.
3. Another indication that most can be received are :
- Recurrent tonsillitis attacks.
- Hyperplasia of tonsils with functional disorders (dysphagia).
- Hyperplasia and obstruction that persist for 6 months.
- Does not respond to management and therapy.
- Fever of unknown cause.
- systemic infection or chronic.
Preparation of operations that may be undertaken :
- Laboratory tests (hemoglobin, leukocytes, bleeding time).
- Give an explanation to the client treatment and care after surgery.
- Fasting 6-8 hours before surgery.
- Give antibiotics as prophylaxis.
- Give premedication ½ hours before surgery.
- Medical history factors associated with the occurrence of tonsillitis supporting bio- psycho- socio- spiritual as well.
- Blood circulation. Palpitations, headache during position changes, decreased blood pressure, bradycardia, body felt cold, pale extremities.
- Elimination. Changes in the pattern of elimination (urinary incontinence / bowel incontinence), abdominal distension, bowel sounds disappearance.
- Activity / rest. There is a decrease in activity due to body weakness, loss of sensation or parese / plegia, tiredness, difficult in the rest because of muscle cramps or spasms and pain. The reduced level of consciousness, decreased muscle strength, general body weakness.
- Nutrition and fluids. Anorexia, nausea, vomiting due to increased ICP (intracranial pressure), impaired swallowing, and loss of sensation on the tongue.
- Innervation. Dizziness / syncope, headache, decreased visual field wider / blurred vision, decreased sensation of touch, especially on the face and extremities. Comatose mental status, weakness in the extremities, muscle paralise face, aphasia, dilated pupils, decreased hearing.
- Comfort. Tense facial expressions, headache, restlessness.
- Breathing. Shortened breath, inability to breathe, apnea, apnea onset period in breathing patterns.
- Security. Fluctuations of the temperature in the room.
- Psychology. Denial, disbelief, anguish, fear, anxiety.
Nursing Diagnosis for Tonsillitis and Post Operative Tonsillectomy