It is commonly seen in children 4 to 7 years of age

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It is commonly seen in children 4 to 7 years of age and rare in less than1 year of age Approx 80% caused by viruses; the rest are caused by bacteria Treatment Antibiotics, comfort measures Left untreated can lead to rheumatic fever Clinical manifestations: Viral Pharyngitis
Nasal congestion Mild sore throat Conjunctivitis Cough Hoarseness Mild pharyngeal redness Minimal tonsillar exudate Mildly tender anterior cervical lymphadenopathy Fever < 38.3 (101.0) Strep throat Abrupt onset Tonsillar exudate Painful cervical lymphadenopathy Anorexia, N/V, abdominal pain Severe sore throat Headache, malaise Fever >38.3 Petechial mottling of soft palate Peritonsillar abscess Fever Malaise Sore throat, more severe on one side Marked erythema and edema, esp of one side of throat, tonsil, and soft palate, sometimes with deviated uvula Mouth odor Difficulty speaking Difficulty opening mouth wide Cervical lymphadenitis Ear pain Retropharyngeal abscess Fever Sore throat Inability to eat Neck pain and edema Pharyngitis Respiratory distress and stridor X. Tonsillitis and Adenoiditis o What to avoid, nursing interventions Inflammation of the tonsils Signs and Symptoms Frequent throat infection, lymphadenopathy
Treatment Symptom management, “watchful waiting” Tonsillectomy o Considered after clear guidelines Disordered sleeping secondary to enlarged tonsils and recurrent infections. Swelling of the tonsils can and often occurs with pharyngitis, but it is not the same as tonsillitis Surgery Guidelines: Indications for the surgery: repeated infections and sleep-disordered breathing 7 episodes of tonsillitis/year 5 episodes/ 2 years 3 episodes a year /3 years Sleep disordered breathing can lead to poor school performance, enuresis, behavior and growth problems Care of for the child after surgery Have the child drink adequate cool fluids to reduce spasms in the muscles surrounding the throat Ensure that the child drinks recommended amount of fluid to avoid dehydration Apply an ice collar around the child’s neck Give Tylenol elixir or other analgesic Have the child gargle with a solution of 2.5 g (1/2 tsp) each of baking soda and salt in a glass of water If ordered by MD, have the child rinse the mouth well with viscous lidocaine or other local anethetic Tonsillectomy complications Bleeding o Most common in the first 24 hours, but can occur anytime within the first 7-10 days o Assess every time you enter the child’s room o Never give red fluids or food Infection
o The back of the throat will look like white and have an odor for the first 7 to 8 days after surgery. The child may also have low grade fever. These are not the signs of infection o For temp >38.3, Tylenol may be used o Call the MD if child develops fever >38.8 Pain o Sips of cool fluids for comfort. Avoid citrus juice o Acetaminophen as ordered o Provide rest and quiet activities for several days

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