TONSILLITIS

Prepared by: Charmaine Joy H. Velasco BSN 3A I. OBJECTIVES At the end of the study, the student-nurse would be able to: know the anatomy and physiology of the body part or organ involved; know the disease, its different causes, specific signs and symptoms, medical managements, and other complications; identify different nursing interventions that are applicable to the condition; and apply the acquired knowledge to an actual situation.

II. INTRODUCTION Clients Pro ile Name: Mr. . Birthdate: !ecember "#, $%&' Age: $( y)o Sex: Male Civil Statu : *ingle Nati!"alit#: +ilipino Religi!": ,oman -atholic Addre : .one /A, *ua, -amaligan Chie$ C!m%lai"t: +ever, *ore throat &re e"t Treatme"t: *elfmedication &a t Treatme"t: 0one &a t '! %itali(ati!": 0one Allergie : 0one O))u%ati!": 0one

Patients History o Present !llness Mr. is a resident of .one /A, *ua, -amaligan, -amarines *ur. 1e has no permanent 2ob and he does sidelines to earn for a living and to earn for his family. 1e spends his time mainly at home, doing some household chores. 1e reported drinking coffee every morning. 1e denies smoking and drinking alcohol. 3n the night of 4une $(, $##', he felt hot and e5perienced a sore throat. 1e thought of having tonsillitis. 1e immediately took A678!30 '## mg. III. *ORDON+S ,UNCTIONAL 'EALT' &ATTERN -. 'ealth &er)e%ti!" . 'ealth /a"ageme"t &atter" 9he patient:s health rating is ". !ue to his present condition, he cannot perform A!6s by himself and he needs assistance by a caregiver or significant other. 1e hasn:t gone yet to a professional health care personnel. 1e doesn:t use tobacco, doesn:t drink alcoholic beverages, and doesn:t take any drugs for abuse. "b#ecti$e

9he patient is alert even though having a bad feeling. 1e is lying on bed to promote rest. 1e communicates well and talks fine. 1e can move his different parts of the body and he shows emotions by different facial e5pressions. &R: /& bpm RR: $$ cpm T 0axillar#1: ;&< B& 0 itti"g1: ""#)%#

2. Nutriti!"al . /eta3!li) &atter" %aily &ood and &l'id !nta(e 1e usually drinks coffee in the morning. +or lunch and dinner, he eats vegetables and rice. 1e often eats fish and seldom eats meat. 1e eats anything available for snacks. 1e doesn:t have any food allergies. 1e drinks appro5imately $6 of water delivered by the water tank that roams in their barangay everyday. 1e doesn:t e5perience difficulty chewing but at present, he is e5periencing difficulty swallowing due to his sore throat. 1is gums and tongue are not swollen but his palatine tonsils are. 1e is not e5periencing abdominal pain and he never took la5atives and antacids. 1is skin, hair, and nail condition are good. 4. Elimi"ati!" &atter" Bo)el Habits 1is usual pattern is everyday, in the morning. 1e never takes la5atives and antacids. 1e never used suppositories. 1is stool color is usually dark brown. 1e never e5perienced pain during defecation. Bladder Habits 1e voids appro5imately & times per day. 9he usual color of his urine is clear to yellow. 1e never e5perience pain during urination. 1e never e5perienced wetting his bed upon waking up. =henever he feels the urge to void, he always does. 1e never e5perienced retention. 5. A)tivit# . Exer)i e &atter" %aily Acti$ities 1e takes a bath daily without anyone:s aid. 1e does cook and do the household chores at times. 1e views A!6s as different forms of e5ercises. 1e eats moderate meals during lunch and dinner. 1e doesn:t e5perience chest pain, stiffness, and palpitations. 1e e5periences headache at times when he:s tired or if the weather is too hot. 1is illness at present resulted to limitation of his activities to promote rest. 6. Slee% . Re t &atter"

1is sleeping time usually starts at %:## >M and he wakes up at ?:## or /:## in the morning. 1e does not have difficulty falling asleep. 1e does not use any sleeping aids. *imply turning off the lights induces his sleep. 1e denies using any sleeping medications. At present, he appears e5hausted due to his illness. 7. Sexualit# . Re%r!du)ti!" &atter" 1e is single. 1e doesn:t have any live-in partner nor does have any children. 8. Se" !r# . &er)e%tual &atter" 1e does not have any problems with hearing, taste, smell, and sensation. 1e does not use any hearing and vision aids. 1e is currently feeling pain in the throat due to the swelling of his palatine tonsils. 9. C!g"itive &atter" 1e is able to e5press himself well by verbali@ing his feelings and showing gestures and manifesting different facial e5pressions. 1e can recall recent and remote memories. 1e is able to make decisions for himself. 1e shows behaviors of a mature gentleman. :. R!le . Relati!" hi% &atter" 1e is the second child in the family. 1e lives with his mother, siblings, cousins, and nephews and nieces. 1e provides e5tra income for the family, sometimes when he has a sideline. 1e does some household chores when he is at home. 1is family communicates well since they all live in one house. 1is relationship with them is quite good. 1is siblings are actually taking care of him at present. -;. Sel$<%er)e%ti!" . Sel$<)!")e%t &atter"

1e believes that he is an average person who wants to provide his family with a good living. 1e believes he is funny at times. --. C!%i"g . Stre T!lera")e &atter"

1is ma2or stressors are problems with the family. +amily and friends are his support system. 1e sometimes watches 97 to rela5 his mind or he 2ust simply listens to the silence. -2. Value . Belie$ &atter"

1e believes that he is silent, simple, and has self-esteem. 1is goal is to provide his family with a good living. 1is sources of hope are his family and friends. 1e is a ,oman -atholic. 1e sometimes goes to church at *undays. 8ven though he forgets to pray at night, he assures that he is still a devoted catholic.

IV. ANATO/= AND &'=SIOLO*= *he *onsils

9onsils are part of the body:s lymphatic system. 9hese are organs which are of importance in the creation of the blood and they are organs which fulfill important tasks: protection and deto5ification of the body and elimination of matter which should be eliminated. 9hey also act as organs for the regulation of the activity of the entire mucous membrane. 9here are three groups of tonsils. 9he pharyngeal tonsils, or adenoids, are located near internal opening of the nasal cavity. 9he lingual tonsil is a rounded mass of tissue on posterior surface of the tongue. 9he palatine tonsils are located on each side of posterior opening of the oral cavity. 9hey usually are AtonsilsB that many people are referring to. the the the the

9he work done by the tonsils is similar to that done by the lymph glands. Cy the formation of new white blood corpuscles and by filtering the stream of the lymph, the germs of disease, metabolic poisons, and the foreign bodies are arrested and are made innocuous. 9onsils and glands fulfill the same function, but there is this difference: the tonsils are not encapsulated in connective tissue. 9hey can e5pand towards throat and mouth and their special formation with deep indentures and clefts makes it possible for the tonsil to get greatly enlarged if necessary. +oreign bodies, body to5ins, and germs, which have been carried into the tonsils by the lymph stream, can therefore be eliminated by way of the mouth, and thus the body is ridded of no5ious materials. 9he lymph circulation is of great importance to our health and the flow of lymph through the tonsils is one of the most important defensive mechanisms of the human body. Dood health requires that the tonsils should function properly. En adults, the tonsils decrease in si@e and may eventually disappear. Nat're o the %isease

9onsils are ovoid masses of lymphoid tissue that act as a filter against disease organisms. 1owever, they often become a site of infection, a condition known as tonsillitis, and sometimes become enlarged. Et is most commonly caused by group A beta-hemolytic streptococcus. According to studies, this microorganism can be present in certain kinds of foods such as fried foods, flesh foods, pickles, tea, coffee, sugar, white flour, and all products that are made with sugar and white flour. 9here is no proof that smoking contributes to its development but research shows that smoking weakens the immune system. *ymptoms of tonsillitis include a severe sore throat which may be e5perienced as a referred pain to the ears, painful and difficult swallowing, coughing, headache, myalgia, fever, and chills. Et is characteri@ed by signs of red and swollen tonsils which may have a purulent e5udative coating of white patches or pus. *welling of the eyes, face, and neck may also occur. 9onsillitis may be acute Fhaving presence of white patchesG or chronic Fpersistent infection having no presence of white patchesG. En any form, it is more prevalent during childhood since tonsil tissue tends to regress with age. Et can occasionally become serious. +or e5ample, infection may spread beyond the tonsil to form an abscess, which is a locali@ed collection of pus. An abscess that forms around an inflamed tonsil is known as a peritonsillar abscess or quinsy. 9his almost always develops on one side only and usually in adults rather than children. Another type of abscess, one that develops mainly in young children, is a retropharyngeal Fbehind the throatG abscess. 9his usually causes high fever and great difficulty in swallowing. 9he most serious complication of tonsillitis is rheumatic fever, which often is accompanied by rheumatic heart disease. ,heumatic fever develops only if the tonsillitis is due to group A betahemolytic streptococcus. Et also usually occurs only in children who have had repeated infections that have not been adequately treated with antibiotics. =hether tonsillitis is caused by a viral or bacterial infection, home care strategies can be made to provide comfort and promote better recovery. 8ncourage the person to get plenty of sleep and to rest his or her voice. >lenty of water should be given to keep the throat moist and prevent dehydration. =arm liquids Fbroth, caffeine-free tea, or warm water with honeyG and cold treats Fice popsG can soothe a sore throat. Ef the person can gargle, a saltwater gargle of " teaspoon of table salt to & ounces of warm water can also help soothe a sore throat. 1ave the person gargle the solution and then spit it out. Et is also important to avoid irritants. Heeping the home free from cigarette smoke and cleaning products can help. Ef tonsillitis is caused by a bacterial infection, the doctor will prescribe a course of antibiotics. >enicillin taken by mouth for "# days

is the most common antibiotic treatment prescribed for tonsillitis. Ef the person is allergic to penicillin, the doctor will prescribe an alternative antibiotic such as erythromycin. 9he person must take the full course of antibiotics as prescribed even if the symptoms go away completely. +ailure to take all of the medication as directed may result in the infection worsening or spreading to other parts of the body. Ef tonsillitis is caused by a virus, like 8pstein-Carr virus or the -o5sackie virus, the length of the illness depends on which virus is involved. Isually viral infection is self-limiting; the body fights off the infection on its own within one week. 1owever, some rare viral infection resolves for up to two weeks. Ef detected very early, peritonsillar or retropharyngeal abscesses can sometimes be treated successfully with antibiotics. En most cases, however, surgery is required to drain the abscess. ,emoval of the tonsils, called tonsillectomy or adenoidectomy, is sometimes advised if frequent inflammation poses a threat to health. 9he lingual tonsil becomes infected less often than the other tonsils and is more difficult to remove. V. NURSIN* CARE &LAN VI. INSI*'T %ate: June 24 25 & July 1 2, 2010 (Thursdays and Fridays) Clinical Area: Sua, Camaligan, Camarines Sur Clinical !nstr'ctor: Mr. J el !e"res, #!, M$! Et wasn:t my first time to be assigned to one of the communities handled by Iniversidad de *ta. Esabel. E can say that E am already confident doing my entire task in the community than when E am in the hospital. My an5iety is already into its minimum. Cut still E:m afraid E might do something wrong that could possibly harm or disappoint my client. 9hanks to *ir 4oel because with him, E knew how to properly interact with the people in the community. E didn:t 2ust gain more confidence but E also learned a lot. 9he first two days of our e5posure was really tiring but at the same time, it was a lot of fun. =alking under the heat of the sun at %:## AM was never part of my dreams. Cut when we did the ocular survey on the first day, E reali@ed that seeing the condition of the community makes a community health nurse proud if he)she has seen a lot of development, or determined if he)she has seen some problems in the community. >roud because when you see that there is a positive change in a certain person or place, you will feel that all your hardships were worth it, and determined because when you recogni@e a negative matter, you will try to do your best to make it a better one. 9he long walk was an e5perience E can never forget. 3n the second day of our e5posure, home visit was the task of the day. Again, walking the long road is a part of it. E, together with one of my ,68 group mates, was assigned on the / th @one of the barangay. E was really shy to walk wearing my -10 uniform. E feel like everyone

was staring at me. Ef E had the chance to, E would take it off and change myself into someone that they can see as themselves. =ith what E felt during that day, E kept into my mind this principle: in order for you to be part of the community, you should be one of the people. E did the home visit well but one thing that makes me uneasy is me having to talk with the residents in tagalog, and they answer me back in bikol. E was really shy because E know it is my task to learn the language but E 2ust can:t speak using it. Maybe one of these days, months, or years, E would learn how to speak with it properly. 9he last two days of our e5posure was mainly spent for reporting and paper works. E reported about EM-E and E guess E did pretty well. >reparation is very important in delivering a report. 9his skill can be applied to activities in the community, wherein the community health nurse has to inform the people about matters in the community. >aper works, especially those that have to be prepared by group, will not be easy if not every member is participating. E was happy on the last day of our e5posure because even if we 2ust stayed in the barangay hall of our school, our time was productive. =e almost finished all that we have to do and the best part is that the moment was spent with the whole group. =ith the four-day e5posure and e5perience, E learned that establishing rapport is really important in all aspects. Et is for the reason that people will not work effectively if they didn:t develop a good relationship with each other, especially in the case of a nurse and a client. Ceing careful is the key for an effective nursing care. 9he client should always be our center. +or me, the best thing to bear in every student-nurse:s mind is this: A-ommon sense does not require a ,0 license.B