Lecture 5 Inflammations and Infections of the Parynx (2 questions) – Flashcards

Also known as sore throat; an infection and inflammation of the mucous membrane of the pharynx

Gradual onset; soreness, dryness, and pain in the throat; Dysphagia; Low-grade or no fever; Throat mildly red

Sudden onset; Soreness, dryness, and pain in throat; Dysphagia; Fever over 101 degrees; Throat intense red-purple with enlarged tonsils and patchy yellow exudate; Muscle and joint pain; Elevated WBCs

Pharynx should be inspected and culture done

Diagnostic test for Strep; results often available w/i minutes

Diagnostic test for Strep; takes longer, but is more accurate

Rest, fluids (cool, bland), warm saline gargles, throat lozenges, ice collar, steam vaporizer, analgesics, antipyretics

Penicillin, Cephalosporin, Erythromycin; take antibiotics until gone and then come back for a recheck to make sure strep is gone

*Acute Glomerulonephritis*, *Rheumatic fever*, Scarlet fever, Otitis media, Peritonsillar abscess (quinsy)

Collection of pus or fluid around the tonsil

Inflammation of the tonsils; may be acute, recurrent, or chronic

Exudate when looking in the throat; look to see how close together tonsils are - can cause respiratory problems if too close together, especially when laying down

Same as for Strep Pharyngitis; Tonsils swollen and red with purulent drainage; cervical lymph nodes enlarged and tender; bad breath (from mouth breathing) Reports of sore throat with difficulty swallowing, History of otitis media and hearing difficulties; Mouth odor, Mouth breathing, Snoring, Nasal qualities in the voice, Fever, Tonsil inflammation with redness and edema

Same as from Strep Pharyngitis (antibiotics); Tonsillectomy and adenoidectomy for recurrent or chronic infections

Review labs including bleeding time, PT, PTT, and CBC (platelets, WBC, H and H); Vital signs, Consent form signed

Assess vital signs (elevated pulse, decreased BP); check nose and throat with flashlight; *Watch for increased swallowing - mostly with pediatric patients*; Watch for clearing of the throat and restlessness - mostly with older patients; Watch for bright red vomitus

Lie prone with head slightly lower than chest or semi-fowlers with head to side; Give no ASA; Avoid straws, forks, or sharp pointed toys; Avoid coughing, clearing the throat, blowing the nose, or sneezing; No strenuous activity for 7-10 days; Give no red popsicles; Avoid milk, ice cream, and pudding (cause clearing of the throat); Stay away from scratchy foods for 10 days; Keep hydrated; teach signs of dehydration - skin turgor, not going to bathroom as much, look at eyes and mucous membranes, lethargic behavior To control pain: ice collar, analgesics (liquid Tylenol), antiemetics, mouth sprays - no gargling, steam vaporizer, throat numbing meds (Clozesepic); Pain is worse for older patients To maintain hydration: force fluids - 2-3 liters/day (Clear liquids at first); no red popsicles

Assess vital signs and respiratory status; position prone with head lower than chest and then semi-fowlers; avoid blowing nose, clearing throat, coughing, and sneezing

D/C the same day; Told to expect tarry stools; Told that a tough, yellow membrane forms over operative site, membrane will break away between the 4th and 8th post-op day; Halitosis common for 10-14 days, do not gargle; Cool mist humidifier may be helpful; Call MD if there is bleeding, fever, or a persistent earache; See MD in 1-2 weeks; Prophylactic antibiotic may be ordered

Most dangerous time following a tonsillectomy when clots are forming over surgical area and then when clots dissolve

Provide symptomatic treatment for viral tonsillitis (rest, cool fluids, warm salt-water gargles); Administer antibiotic therapy for bacterial tonsillitis; Administer medications, as prescribed

Antipyretics, Antibiotics, Analgesics

Type of medication that decreases fever

Encourage use of warm salt-water gargles and throat lozenges; Encourage fluid intake and monitor hydration status until NPO

Position on their side to facilitate drainage; Elevate head of bed when fully awake; Assess for signs of bleeding, which include frequent swallowing, clearing the throat, restlessness, bright red emesis, tachycardia, and/or pallor; Assess airway and vital signs; Monitor for any difficulty breathing related to oral secretions, edema, and/or bleeding; Provide an ice collar and analgesics; Keep throat moist; Administer pain medication on a regular schedule; Encourage clear liquids and fluids after a return of gag reflex, avoiding red-colored liquids and milk-based foods initially; Advance diet with soft, bland foods; Discourage coughing, throat clearing, and nose blowing in order to protect the surgical site; Refrain from placing pointed objects in the back of the mouth; Alert parents that there may be clots or blood-tinged mucus in vomitus

Instruct family to notify health care provider if signs of bleeding occur; Encourage child to rest; Instruct parents to contact provider if child experiences difficulty breathing, bright red bleeding, lack of oral intake, an increase in pain, and/or any signs of infection; Tell parents to ensure child does not put anything sharp (ice-cream stick, straw, any pointed object) into mouth; Teach parents to administer pain medication for discomfort; Encourage fluid intake and diet advancement to a soft diet with no spicy foods or hard, sharp foods like corn chips; Instruct child and family to limit strenuous activity and physical play with no swimming for 2 weeks; Instruct child and family that full recovery usually occurs w/i 10 days to 2 weeks