Care Conference Tonsilitis...

1. BY : SRN NOORHAZAMIN
NURSING EDUCATION SERVICES

2. 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.

3. LEARNING OBJECTIVES
cont.
Identify the complication of
tonsilitis.
Identify the nursing
intervention & appreciate the
nursing care for tonsilitis
patient.

5. PATIENT’S PROFILE
 MISS. A
 FEMALE
 23 YEARS OLD
 STUDENT

6. PATIENT’S PROFILE
 WALKED IN
 CALM
 ALLERGICS - NIL
 D.O.A 3/5/12 @ 1040H

7. Doctor = Dr F
Diagnosis
= RECURRENT
TONSILITIS

8. PATIENT’S PROFILE
 MEDICAL HISTORY
 Tonsilitis & rhinitis since Nov
2011
 SURGICAL HISTORY
 Nil
 FAMILY MED HISTORY
 Sinusitis (father)

9. CURRENT MEDICATION
 Efurox 1 BD
 Aerius 5mg Nocte

11. VITAL SIGN
 TEMPERATURE : 36.0˚C
 BLOOD PRESSURE : 120/70mmHg
 PULSE : 80 bpm
 RESPIRATION : 21 bpm
 PAIN SCORE : 5

12. ACTIVITY DAILY
LIVING
 Having difficulty in swallowing
and pain during swallowing
 Loss of appetite
 Anxious and asking many
questions.

13. PHYSICAL
EXAMINATION

14. S/B Dr F in clinic
Surgical Profile
 NBM
 For tonsilectomy

18. 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

19. 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

22. 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

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

34.  Haemoglobin 11.3g/dL (11.5-16.0)
 Sodium 134mmol/L (135-
155)

37. DRUGS
ORDERED ON PRE MED
DATE
ORDERED
Tab Zantac 150 mg STAT 3/5/12
Tab Maxalon 10 mg STAT 3/5/12
Tab Celebrex 200 mg STAT 3/5/12

38. DRUGS
POST OPERATIVE
DATE
ORDERED
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

46. Alteration in comfort
pain related to
sorethroat.
NURSING DIAGNOSIS

47.  Alteration in
emotional status
anxiety related to
surgical procedure.
NURSING DIAGNOSIS

49. NURSING DIAGNOSIS
 Potential bleeding
related to surgical
wound.

50. NURSING DIAGNOSIS
Potential infection
related to surgical
incision.

51. NURSING DIAGNOSIS
 Potential infection
related to intravenous
cannula insertion.

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