Nursing Assessment and Management of Tonsillitis in Children

This report discusses the nursing care assessment and management of a 6-year-old boy with tonsillitis and peritonsillar abscess. It includes a discussion of the Paediatric Assessment Triangle, effective nursing care plan goals, and health promotion programs. References are also provided.

YOUNG AND CHILD

Table of Content.
INTRODUCTION...........................................................................................................................1
MAIN BODY...................................................................................................................................1
CONCLUSION................................................................................................................................1
REFERENCES................................................................................................................................2

INTRODUCTION
The care nurses generally encompass an autonomous as well as a collaborative care of
people as well as children of all age groups, families as well as societies, both ill and well-being
people in every sector. The care nurses can involve the promotion of well-being, the prevention
of disease as well as care of disabled, sick, or dying individuals (Sara et. al., 2021). In this,
advocacy, research, promotion of a safe environment, engagement in shaping a health policy as
well as inpatient and well-being system management and education are generally also key
nursing care roles. In this report, there is a discussion about the case scenario of Joe who is a 6-
years-old boy and is admitted to an emergency department due to high fever, ear pain, having
difficulty swallowing, and vomiting. There is a discussion about nursing care assessment and
management of his underlying conditions of Joe and to make him healthy and prevent his illness;
there is a discussion about some of the effective health promotion programs (Zaman et. al.,
2021).
PATHOPHYSIOLOGY
Joe is a 6-year-old boy, admitted to an emergency department involving a 3 days history
of ear pain, fever, difficulties in swallowing, and vomiting as well. In this, his diagnosis can
involve severe tonsillitis and this was his 3rd admission within healthcare following the same
diagnosis. Joe has been on an intravenous antibiotic; he was given an anti-inflammatory
medication and IV fluids in the last 24 hours. In the morning, during the daily routine rounds of
the ward, Joe was re-examined and was found by the care nurse to be drooling with moderate
respiratory suffering. As per the case scenario, the second diagnosis of a peritonsillar abscess
was made and was scheduled for quinsy tonsillectomy within four hours. It has been observed
that the heart rate of Joe was 139 beats per minute
Temperature = 39.3 degree Celsius
Oxygen saturation level = 91% on room air
Respiratory rate = 34 breaths per minute
Capillary refill = <2 seconds
Blood pressure = 95/72 mm Hg
From the diagnosis, it is also identified that Joe has a mild autism disorder when he was 2-year-
old. In addition to this, the etiology of Tonsillitis can be caused by viruses and bacterial
infections as well. The most common bacteria that can cause tonsillitis is Streptococcus
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pyogenes, which can cause strep throat (Xie, Donaldson & Margolin, 2021). Among children,
tonsils are generally the first line of defense of the immune system against both viruses and
bacteria which can enter the mouth. Such functioning can specifically make the tonsils more
vulnerable to inflammation or infections as well. Therefore, the immune system functioning of
tonsils can decline after puberty and is a factor that can account for some of the rare cases of
tonsillitis among adults. As per his diagnosis, the peritonsillar abscess is generally a
complication of tonsillitis in which an infection can effectively spread behind the tonsils. It can
occur when an aggregation of pus is formed as well as the infection can spread beyond the
tonsils into the chest and neck as well. The swollen tissues can effectively block the airways
(Ghavami et. al., 2021).
NURSING ASSESSMENT AND MANAGEMENT
In the nursing assessment and management, the Paediatric Assessment Triangle is generally
a quick evaluation tool that mainly establishes a clinical status of a child and their category of
disorders to direct the initial management priorities. The tool can generate a rapid, as well as a
global assessment using only visual as well as auditory clues; it generally needs no equipment
and can take a few minutes to perform. The assessment tool was designed to allow the care
provider to coherent formally a general impression of the child, can create the strictness of the
demonstration and its grouping of the pathophysiology, and can identify the types as well as the
urgency of the effective interventions. In addition to this, by using the Paediatric Assessment
Triangle, the care provider can specifically make the thought of the 3 components: appearance,
work of breathing as well as circulation to the skin (DHRUV, 2019).
Appearance: It generally reflects the age of a child, developmental stage as well as the
ability to interact with the surrounding environment. In this, the essential clues like the tone of
the baby, their interaction with the care provider, console-ability, and many others. In addition to
this, the strength of crying can specifically enlighten the care provider about the appearance of
the child as normal or abnormal.
Work of breathing: In this component of the Paediatric Assessment Triangle, it can
specifically illustrate the respiratory status of a child, especially the degree to which the child
must work to oxygenate as well as ventilated. The clinical signs, for example, the abnormal
sound of the airways like grunting, stridor as well as wheezing sound, retractions, abnormal
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positioning, or the flaring of the nostrils during inspiration can effectively identify an enhanced
or abnormal work of breathing.
Circulation to the skin: It can exhibit the general perfusion of the blood all over the body.
The care provider generally notes the color pattern of the skin as well as the mucous membranes.
In contrast, with the loss of fluid or blood in the venous tone, the compensatory mechanism can
shunt the blood towards all the vital organs within the body like the brain and heart and away
from the periphery of the skin and body as well. by addressing the alterations within the color of
skin as well as the skin perfusion like cyanosis or pallor, the care provider can recognize the
early signs of the shock (Leung et. al., 2021).
The effective nursing care plan goals for Joe experiencing tonsillitis can involve maintaining a
patient airway, preventing the aspiration, and can relieving the pain, more specifically while
swallowing and boosting the intake of fluid as well as an understanding of the post-discharge
care and a possible complication such as acute pain, an ineffective clearance of airways, the risk
for deficient fluids (Virbickaitė, 2018).
HEALTH PROMOTION
To prepare Joe and his family before surgery, the care nurses must develop an effective
relationship with both Joe and his family with help of effective communication. Having a
conversation with the patient and their family member can help the care nurses to build trust as
well as can provide the care treatment as per their requirements (Toscano et. al., 2021).
Communication can help the care nurses and patients to build trust and the patient can share all
their emotions and feelings and can make them feel comfortable with their care providers. The
caring nurse ensures that Joe and his family about the surgery and can involve in the care
treatment plan of Joe so that the family members can also be familiar with Joe’s treatment plan.
They must also know all the details about the care treatment plan and which care plan can suit
best Joe (Boiko et. al., 2018).
CONCLUSION
From the above discussion, it is analyzed that Joe is a 6-years-old child, suffering from
tonsillitis and peritonsillar abscess. He has generally faced difficulties in swallowing also. To
treat his condition, the care nurses plan surgery for him so that he can effectively recover from
his unbearable pain. There is also a discussion about the Paediatric Assessment Triangle in the
nursing assessment and management for the child’s name Joe to prevent his issues caused by
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tonsillitis. There is a health promotion approach discussed above that can help both Joe and his
family before the surgery of Joe such that they both cannot get nervous. It is determined from the
discussion that effective programs can effectively support as well as empower both Joe and his
family to choose healthy behaviors. It can specifically allow an individual to enhance their
control over their well-being.
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REFERENCES
Books and Journals:
Ababiy, I., Danilov, L., Ginda, S., Manyuk, M., Ababii, P., & Kostinov, M. (2018). Clinical and
immunological efficacy of conjugated pneumococcal vaccine in children with
compensated chronic tonsillitis. Pediatriya-Zhurnal im GN Speranskogo, 97(2), 134-
139. https://doi.org/10.24110/0031-403x-2018-97-2-134-139
Boiko, N. V., Kim, A. S., Stagnieva, I. V., Lodochkina, O. E., & Filonenko, N. A. (2018). The
significance of antistreptolysin O characteristics for the determination of indications for
tonsillectomy in the children. Vestn. Otorinolaringol., 83(4),
73. https://doi.org/10.17116/otorino201883473
Ghavami, S., Gombert, E., De Sandre, C., & Lambercy, K. (2021). De l’angine simple à l’abcès
périamygdalien. 17(753), 1690–1693. https://doi.org/10.53738/revmed.2021.17.753.1690
Leung, C. (2021). The younger the milder clinical course of COVID‐19: Even in
newborns? Pediatr Allergy Immunol, 32(2), 358–362. https://doi.org/10.1111/pai.13371
Piper, R. J., & Magdum, S. A. (2019). Chiari 1 malformation and raised intracranial
pressure. Childs Nerv Syst, 35(10), 1719–1725. https://doi.org/10.1007/s00381-019-
04232-x
Sara, H., Bouchra, O., Fakir Samira, E., & Samir, A. (2021). P055 Title: Standard rate of
ASLO in healthy children with streptococcal (angina) or post-streptococcal (RAA)
infection in
Morocco. 60(Supplement_5). https://doi.org/10.1093/rheumatology/keab722.047
Toscano, S., Lo Fermo, S., Reggio, E., Chisari, C. G., Patti, F., & Zappia, M. (2020). An update
on idiopathic intracranial hypertension in adults: a look at pathophysiology, diagnostic
approach and management. J Neurol. https://doi.org/10.1007/s00415-020-09943-9
Xie, J. S., Donaldson, L., & Margolin, E. (2021). Papilledema: A review of etiology,
pathophysiology, diagnosis, and management. Survey of
Ophthalmology. https://doi.org/10.1016/j.survophthal.2021.11.007
Zaman, N., khan, K., Zaman, F., & zaman, B. (2021). Prescribing frequency, trends and patterns
of Antimicrobial therapy in patients with acute tonsillitis: A review. Bulletin of
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