tonsillitis

APPLIED MEDICAL SCIENCE COLLEGE

FOR FEMALES, ALNAMAS UNIVERSITY
OF BISHA MINISTRY OF EDUCATION
KINGDOM OF SAUDI ARABIA
Adult Care Nursing
D:Eman
SIMA SAEED
 1.TONSILS 11.MEMBRANOUS
TONSILLITIS
12.PARENCHYMATOUS
2.THE TONSILS CONSTITUTE TONSILLITIS

13.DIAGNOSIS
3.TONSILLITIS
14.COMPLICATIONS
4.ANATOMY

index 5.PATHOLOGY
16.PREVENTION

15.ALLOPATHIC TREATMENT
6.CAUSES
17.REFERENCES
7.TRIGGERING FACTORS
18.TONSILLITIS NURSING
8.SIGNS PROCESS

9.SYMPTOMS 19.SURGICAL TREATMENT

TONSILLITIS
10.CATARRHAL TONSILLITIS
20.NURSING MANAGEMENT
 tonsillitis
Tonsils
Tonsils are protective (lymph) glands that are situated on both
sides in the throat.

• The tonsils constitute an important part of the body's

immune system and are vital defense organs.

• They protect the body from bacteria and viruses by fighting

these as soon as they enter the body (via the oral / nasal cavity).
 TONSILLITIS

TONSILLITIS
• INFLAMMATION OR INFECTION OF THE TONSILS IS
MEDICALLY TERMED AS TONSILLITIS.
TONSILLITIS IS INFLAMMATION OF THE TONSILS, TWO
OVAL-SHAPED PADS OF TISSUE AT THE BACK OF THE
THROAT — ONE TONSIL ON EACH SIDE. SIGNS AND
SYMPTOMS OF TONSILLITIS INCLUDE SWOLLEN
TONSILS, SORE THROAT, DIFFICULTY SWALLOWING
AND TENDER LYMPH NODES ON THE SIDES OF THE
NECK.
ANATOMY
• In the normal state, tonsils are pink in color (similar to their surroundings tissues) and
about the same size.
• The tonsils along with adenoids are said to form the 'first line of defense' against infective
organisms

PATHOLOGY
When the tonsils get inflamed, they become red, swollen and may develop pus pockets that
start exuding a discharge.
• In cases with recurrent infections, the tonsils may become so swollen over a period of time
so as to almost touch each other.
• Tonsillitis is very common amongst children.
• No particular gender predilection is seen
CAUSES
Bacterial and viral infections can cause tonsillitis through droplet infection.
• A common cause is Streptococcus bacteria.
• Other common causes include: o Adenoviruses o Influenza virus o Epstein-Barr virus o
Parainfluenza viruses o Enteroviruses o Herpes simplex virus
TRIGGERING FACTORS

Peanuts Cold foods, cold drinks, Changes of weather. Extremely

Ice creams. cold climate,
Damp weather.

Foods with artificial colors Exposure to a lot of

and preservatives. pollution.
 SIGNS
ENLARGED LYMPH NODES WHITE SPOTS (SPECKS OR
IN NECK REGION PATCHES) ON THE TONSILS COUGH

Bad and foul breath Red and swollen tonsils Running Nose
 Soreness of throat

SYMPTOMS • Difficulty in swallowing or painful swallowing

of food and drinks
• Pain / discomfort while swallowing saliva

Change of voice
• Pain in the ears (due to common nerve supply
of the back of the throat and ears)
• Headache

Malaise, tiredness
• Difficulty in taking feeds in babies - this may
be the sole indicator in some cases of tonsillitis
in infants
1. CATARRHAL TONSILLITIS : When tonsils are inflamed as part of the generalised infection of the
oropharyngeal mucosa it is called catarrhal tonsillitis.
2. MEMBRANOUS TONSILLITIS : Some times exudation from crypts may coalesce to form a membrane
over the surface of tonsil, giving rise to clinical picture of membranous tonsillitis.
3. PARENCHYMATOUS TONSILLITIS :When the whole tonsil is uniformly congested and swollen it is called
acute parenchymatous tonsillitis
4. DIAGNOSIS: Examination of the throat in tonsillitis: • Redness and swelling of the tonsils • Pus pockets
on the tonsils • Discharge from the tonsils • In case of peritonsillar abscess, there may be a shift of the
involved tonsil towards the center of the throat. The uvula may be shifted towards the opposite side
(away from the affected tonsil).
5. DIAGNOSIS: Throat swab :This is used to get a sample of the secretion from the back of the throat. •
Monospot test: A blood test can detect certain antibodies, which can help confirm that a person’s
symptoms are due to mononucleosis. • Epstein-Barr virus antibodies: If a monospot test is negative,
antibodies in the blood against EBV might help diagnose mononucleosis. • Blood tests: This primarily
includes a complete blood count (CBC) which is done to confirm the presence of infection.

COMPLICATIONS:
• Local: Severe swelling with spread of infection and
inflammation to the hypopharynx and larynx may
occasionally produce increasing respiratory obstruction,
although it is very rare in uncomplicated acute tonsillitis.
COMPLICATIONS • Peritonsillar abscess is one of the
complications of acute tonsillitis and its development means that
infection has spread outside tonsillar capsule. • Spread of
infection from tonsil or more usually from a peritonsillar abscess
through the superior constrictor muscle of the pharynx first
results in cellulitis of the neck and later in parapharyngeal space
abscess.
The systemic or general complications of acute tonsillitis are rare
and almost confined to childhood.
• Septicemia: Untreated acute tonsillitis can result in septicemia
with septic abscesses, septic arthritis and meningitis
ALLOPATHIC TREATMENT

Acetaminophen & Ibuprufen are given for relieving the symptoms.

• Antibiotics are prescribed once bacterial infection is confirmed.
• Tonsillectomy –
• For those children's who do not repond to antibiotics
• Quinsy - It is usually treated by draining the abscess and antibiotics.
Sometimes removing the tonsils is needed to treat quinsy.

PREVENTION

Avoid close contact with others who are sick.

• Keep children away from kids who are known to have tonsillitis or a sore
throat.
• Remind kids about the importance of proper hand-washing, especially
when around people who appear to be sick.
• Wash and disinfect surfaces and toys.
• Teaching kids to cover their mouths when coughing or sneezing,
preferably using a tissue so that germs do not get on their hands. And show
them how to use tissues to wipe their noses.
• Carry disposable wipes and a hand sanitizer to clean hands
surgical treatment tonsillitis
TONSILLECTOMY
is the surgical removal of the tonsils, two oval-shaped pads of tissue at the back of the
throat — one tonsil on each side.

A tonsillectomy was once a common procedure to treat infection and inflammation of the
tonsils (tonsillitis). Today, a tonsillectomy is usually performed for sleep-disordered
breathing but may still be a treatment when tonsillitis occurs frequently or doesn't
respond to other treatments.
 tonsillitis nursing process
maintaining a patent airway
preventing aspiration
relieving pain
especially while swallowing encouraging fluid intake
and understanding of post-discharge care and possible complications.

Nursing Diagnosis
• Ineffective air way clearance related to pus or mucous formation secondary to
inflammation
• Acute pain related to the presence of inflammation in tosil.
• Imbalanced Nutrition Less Than Body Requirements related to inadequate intake.
• Hyperthermia related to acute infection by microorganisms.
• Disturbed Sleep Pattern related to the pain in the tonsil area.
 Nursing Interventions
• Abdomen or side lying position to facilitate drainage of
secretions.
• Tepid sponging to reduce temprature.
• A soft to liquid diet is preferred.
• Warm salt water gargles
• Administer analgesic and antipyretic as ordered.
• By explaining cause of disease will relief patient anxiety.
 tonsillectomy nursing
PAIN MANAGEMENT

OTHER COMFORT MEASURES SUCH AS

ICE COLLAR OR HUMIDIFIED OXYGEN management
ORAL INTAKE OF FLUID

ENCOURAGE THE PATIENT TO DRINK

FLUIDS

ALL NURSES USE HUMIDIFIED O2

 references
HTTPS://WWW.SLIDESHARE.NET/VANDANAVALLURI/TONSIL
LITIS-48105665

HTTPS://WWW.SLIDESHARE.NET/DRANGELOSMITH/TONSILL
ITIS-38166423

HTTPS://WWW.SLIDESHARE.NET/SHAFAATULLAHKHATT/TO
NSILITIS-AHN