Are Tonsils really that Important?

Tonsilitis and Adenoitditis


Have you ever wondered why some people tend to have their tonsils removed? Why so? Is there a use to it? here are some information that will help you understand more about tonsils and its surgical procedures.

General Information: Tonsils and adenoids are lymphoid tissues circling the pharynx and form part of the Waldeyer's Ring. This ring is believed to filter and protect the respiratory and gastrointestinal tracts against invation b pathogenic microorganisms. It is also known to have a role in antibody formation. Up to 5 years of age, the child's susceptibility to infection is great. But as the child's immunity increases through immunizations and exposures, the protective role of Waldeyer's Ring decreases.

Signs and Symptoms:

  • Persistent sore throat
  • Offensive breath odor
  • Dysphasia; mouth breathing
  • Cervical lymphadenopathy
  • Impairment for taste, smell and hearing

Indications for Tonsillectomy and adenoidectomy (T & A): Chronic peritonsillar and retrotonsillar for tonsillectomy abscesses (enlarged tonsils are not indications for surgery). Surgery can be done 2 to 3 weeks after infection has subsided to prevent spread of organisms to other parts of the body.

Nursing Management:

  • Preoperative nursing care
  1. Parents should be informed the child about the operation prior to hospital admission.
  2. Laboratory tests (bleeding time, clotting time, platelet smear; CBC) as well as Physical examination and routine urinalysis are done.
  3. Withhold solid foods after supper the night before surgery and liquid breakfast early on the day of the operation.
  4. Atropine Sulfate is given preoperative - reduces formation of respiratory secretions.
  • Postoperative nursing care - PREVENT HEMORRHAGE, which is the most common complication.
  • Immediate post-op:
  1. Position on prone/semi-prone to facilitate drainage of secretions (Reminder: suctioning is never done in a T & A).
  2. Observe for signs of hemorrhage: -Restlessness, pallor, cool skin

                                                              -Decreased BP, increased PR and RR

                                                              -Frequent swallowing

  • When alert/awake
  1. Allow child to sit upright
  2. Chipped ice or ice cream is given in an hour or two. Cold reduces edema in the operative site.
  3. Encourage small servings of soft food (chewing increases circulation and thus promote healing).
  • Discharge instructions
  1. Restrict activities for 2 weeks more.
  2. Eat soft, cool, easy to swallow foods for several days.
  3. Drink plenty of fluids.
  4. Avoid coughing, gargling, or clearing of the throat. Only rinsing fo the mouth is allowed.





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