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It is commonly seen in children 4 to 7 years of age and rare in less than1 year of ageApprox 80% caused by viruses; the rest are caused by bacteriaTreatmentAntibiotics, comfort measuresLeft untreated can lead to rheumatic feverClinical manifestations:Viral Pharyngitis
Nasal congestionMild sore throatConjunctivitis CoughHoarsenessMild pharyngeal rednessMinimal tonsillar exudateMildly tender anterior cervical lymphadenopathyFever < 38.3 (101.0)Strep throatAbrupt onset Tonsillar exudatePainful cervical lymphadenopathyAnorexia, N/V, abdominal painSevere sore throatHeadache, malaiseFever >38.3Petechial mottling of soft palatePeritonsillar abscessFeverMalaiseSore throat, more severe on one sideMarked erythema and edema, esp of one side of throat, tonsil, and soft palate, sometimes with deviated uvulaMouth odorDifficulty speakingDifficulty opening mouth wide Cervical lymphadenitisEar painRetropharyngeal abscessFeverSore throatInability to eatNeck pain and edemaPharyngitisRespiratory distress and stridorX.Tonsillitis and AdenoiditisoWhat to avoid, nursing interventionsInflammation of the tonsilsSigns and SymptomsFrequent throat infection, lymphadenopathy
TreatmentSymptom management, “watchful waiting”TonsillectomyoConsidered after clear guidelinesDisordered 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 tonsillitisSurgery Guidelines: Indications for the surgery: repeated infections and sleep-disorderedbreathing 7 episodes of tonsillitis/year5 episodes/ 2 years3 episodes a year /3 yearsSleep disordered breathing can lead to poor school performance, enuresis, behavior and growth problemsCare of for the child after surgeryHave the child drink adequate cool fluids to reduce spasms in the muscles surrounding the throatEnsure that the child drinks recommended amount of fluid to avoid dehydrationApply an ice collar around the child’s neckGive Tylenol elixir or other analgesicHave the child gargle with a solution of 2.5 g (1/2 tsp) each of baking soda and salt in a glass of waterIf ordered by MD, have the child rinse the mouth well with viscous lidocaine or other local anetheticTonsillectomy complicationsBleedingoMost common in the first 24 hours, but can occur anytime within the first 7-10 daysoAssess every time you enter the child’s roomoNever give red fluids or foodInfection
oThe 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 infectionoFor temp >38.3, Tylenol may be usedoCall the MD if child develops fever >38.8PainoSips of cool fluids for comfort. Avoid citrus juiceoAcetaminophen as orderedoProvide rest and quiet activities for several days