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New Pharyngitis

New Pharyngitis

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Published by: raymondblade18 on Oct 07, 2009
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12/28/2012

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UNIVERSITY OF PERPETUAL HELP SYSTEM – LAGUNA Sto.

Niño Biñan, Laguna College of Nursing

Case Study (Ulcerative Pharyngitis)

Ilagan Richard M.
BSN4-L GROUP46

INTRODUCTION
What is Ulcerative Pharyngitis?
>often simply referred to as a sore throat - is inflammation of the pharynx, the portion of the throat that lies just beyond the back of the roof of the mouth and stretches to the Adam's apple (pharynx). It usually occurs when viruses (or sometimes bacteria) from a cold, flu, or sinus infection involve the throat >inflammation of the pharynx marked by ulceration of the mucosa; may have a viral etiology.

What are the causes of Pharyngitis?
• • • • • • • • • • • • • •

Viral Adenovirus Influenza Gonorrhoea Diphtheria Oral candidiasis Epiglottitis Nasopharyngeal carcinoma Peritonsillar abscess Bacterial throat infection Throat scratches Swallowed corrosives Viral throat infection Chronic smoke exposure

What are the signs and symptoms of Pharyngitis?
Symptoms of Pharyngitis The most common symptoms are:
• • • • • •

Sore or red, raw throat Difficulty speaking or swallowing Tender, swollen lymph nodes (glands) in the neck Fever Headache Earache

Patient’s Profile
Name: Baby V AGE: 10months Address: San Pedro Laguna Date of Birth: September 17, 2009 Place of Birth: Laguna Nationality: Filipino Religion: Catholic Father’s Name: Mr.G Mother’s Name: Mrs. G Admitting Diagnosis: Fever Final Diagnosis: Ulcerative Pharyngitis

Chief complaint:
FEVER

History of present illness: 1day PTA Onset of fever (39˚c) No oral intake (-) Cough, Colds (-) Vomiting (-)Diarrhea Persistence of above condition prompted admission (-) DOB (-) Vomiting Maternal and Birth History U/R Feeding History U/R

PHYSICAL ASSESSMENT
• • (-) TENDERNESS (-) BM

GENERAL: • • • SKIN: • • NO JAUNDICE FLUSHED SKIN CONSCIOUS WEAK DROWSY

UPPER & LOWER EXTREMITIES: • (-) RASHES

HEAD: • SYMMETRIC • SYMMETRIC FACIAL MOVEMENTS EYES: • PINK PALPEBRAL AND BULBAR CONJUNCTIVA • PERI- ORBITAL EDEMA

EARS: • SYMMETRICAL • NO SECRETIONS NOSE: • (-) COLDS

ABDOMEN:

Medical Management
Date and Time 09/17/09 Doctor’s order  Pls. admit to ROC in service of Dra. Omalin  Secure consent  NPO temporarily  Monitor VS Q2; I & O Q shift  IVF D5.03 Nacl 500cc at 56-57 cc/hr  Dx: CBC with UA  Tx: Ampicillin 225mg IV Q6 ANST( )  Aeknil 25mg IV Q4 for T > 38.5  Paracetamol drops 1ml Q4 T > 37.8

10am

11:25am

 Do IV testing of Ampicillin and inject 0.5cc monitor for 15mins for any untoward S & Sx of allergic reaction  Xylogel TID  DFA  Herpex 200mg/5ml 2.5ml QID  D5.03Nacl 500cc @ same rate  IVF D5IMB 500cc x 56ugtts/min  D5IMB 500cc x 56 ugtts/min  Decrease IVF to 25 ugtts/min  Shift to cephalexin 100mg 1.25 Q 8hr  To start one IV

3:25pm 6:15pm 9/18/09 4:30pm

09/19/09 8am

meds consumed  MGH  Home meds - Cephalexin 100mg/ml 1.25 ml Q 8hr x 7days 7am-2pm-10pm - Herpex 200mg/5ml 2.5ml 4x a day (to consume) 8am-12nn-4pm-8pm - Xylogel 3x a day

Anatomy and Physiology

Throat anatomy

Structures of the throat include the esophagus, trachea, epiglottis and tonsils.

PATHOPHYSIOLOGY

Laboratory Results
Hematology Components Hemoglobin Hematocrit RBC Values Male 120-180 gm/L Female 110-140 gm/L Male 0.40-0.54 Female 0.37-0.47 Male 4.5-6 x 10/L Female 4.0-5.7 x 10/L 4-10 x 10 /L 09/17/09 Result = 117 g/l = .36 = 4.5

Total WBC

= 15.5

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