Discussion
Tonsils are two oval-shaped pads located in the back of the throat. The inflammation of the tonsils causes tonsillitis (Sirajudeen et al., 2019). The major symptoms of tonsillitis include difficulty in swallowing food, sore throat and tendering of the lymph nodes. Most of the tonsillitis cases are caused due to viral or bacterial infections. In young children drooling and shortness of breath are also considered as signs of the tonsillitis (Tan et al., 2022). It is essential to consult a physician if the condition starts to worsen. Joe also has also shown similar symptoms. Later the condition worked to a peritonsillar abscess which is a further complication of tonsillitis. In this assignment, the condition of Joe would be evaluated with the help of the supporting literature. The paper would discuss about the physiology, nursing assessments and management with the help of the Paediatric Assessment Tool and/or Primary Assessment Framework and provide a health promotion strategy for Joe family.
Tonsillitis develops if a virus, bacteria and pathogen affect the tonsils causing it to be inflamed (Krüger et al., 2021). The inflammatory response of the viruses is regulated by cytokines. The acute tonsillitis is caused due to the bacteria is due to group A β-hemolytic streptococcus (GABHS) Streptococcus pyogenes infection. The bacteria and the viruses can infiltrate in the tonsillar epithelium ultimately incisive in the mucosal films located in the oral and the nasal cavity. The viral tonsillitis is developed by the following virus which are the Rhinovirus, Adenovirus, Rubeola virus, Influenza and Epstein Barr virus. Tonsillitis is known as chronic if such a condition is persistent for 3 months. The bacteria tonsillitis is majorly caused due to the Streptococcus pyogenes (Kanaem AL-Ibady et al., 2019). The bacteria adhere to the tonsillar surface with the help of lipoteichoic acid (LTA), which is a depositing fibronectin molecule that binds to the tonsillar epithelium. This led to the formation of colonization. The recurrent bacterial tonsillitis is caused due to another type of bacteria known as Staphylococcus aureus. These bacteria penetrate the tonsils with the help of microbial surfaces. After the penetration, the bacteria are internalized by the non-phagocytic cells through the fibronectin-binding protein and beta integrins. The condition of the Peritonsillar abscess is caused due to the blockage of the tonsillar crypt which leads to acute tonsillitis (Levi et al., 2020). The reaction is caused due to the antigenic response in the tonsillar crypt mucosa which leads to the lymphocytic interaction. This causes a sore throat, fever and difficulty in swallowing.
The paediatric assessment triangle is a rapid evaluation tool which establishes the clinical status of the child based on their illness (Kawai et al., 2018). It uses visual and auditory clues without any other external equipment and takes only seconds to perform. The paediatric assessment triangle was established to enable the provider to understand the condition of the child based on the three components which are the appearance, work of breathing and the circulation to the skin. According to this framework, Joe’s appearance would be taken into consideration which includes if his tone sounds abnormal, if he can look properly or if he has abnormal speech. The second which would be considered is the working of breathing abnormal sounds, in Joe’s case it was found that he was having respiratory distress (Kumar et al., 2019). As the circulation to the skin, no colour change was observed. Therefore, it can be analysed that the Paediatric Assessment Tool can be employed in the case of Joe to understand any deterioration or escalation.
Pathophysiology
There are in total three principles for providing family centred care for the children. 1. It is essential for the family members to openly communicate with the family members for improved satisfaction of the parents. 2. It is also essential to understand to recognize the importance of the family (Wang et al., 2018). The family members need to be provided with all the details of medication and surgery and also keep them present during the time in order to get more support for the surgery. This would also create a healing environment. 3. It is essential for the nursing associates to provide respect and honour for cultural differences. The healthcare associate working in the paediatric department needs to promote a positive culture which would contribute to positive health outcomes for the patients (Huang et al., 2020). In the case of Joe, the family need to be kept informed regarding Joe’s condition if there are boundary in communication the nurses can be used body language or translation tool to communicate with Joe’s parents.
Nursing management consists of implementing leadership practices by employing the healthcare care profession including the nurses in decisions making (Lamb et al., 2018). The process for such includes the planning, organization, staffing, directing and controlling. The registered nurses are mainly responsible for such roles. The registered nurse is the person who supervises the condition of Joe in the paediatric ward. They are accountable for the medication and care provided to the patients.
It can be analysed that Joe has autism and also does not like the sound. If the surrounding area may create noise, it might impact the Joe condition as he can feel irritating. The registered nurses need to take care of this parameter. The registered nurses should also look after the medication provided to Joe and educate his Parents about the surgery and the possible complication that can take place.
The action plan for the family after Joe’s tonsillectomy surgery is to educate the family member to not give Joe any blood-thinning medication which includes aspirin and ibuprofen (Hahn et al., 2021). This plan is suggested after reviewing from the physicians. It is essential for the nurses to educate the family about the surgical procedure and explain how blood-thinning medication can cause a delay in the process of clotting of blood and also delays the healing process. It is also essential for the family to know about drinking or eating after midnight should not also be done. As such can cause complications at home and may also further develop breathing problems.
Conclusion:
From the above analysis, it can be analysed that tonsils are two oval-shaped pads located in the back of the throat. The inflammation of the tonsils causes tonsillitis. The major symptoms of tonsillitis include difficulty in swallowing food, sore throat and tendering of the lymph nodes. Most of the tonsillitis cases are caused due to viral or bacterial infections. In young children drooling and shortness of breath are also considered as signs of the tonsillitis. The paediatric assessment triangle is a rapid evaluation tool which ingrained in the clinical status of the child based on their illness. It uses visual and auditory clues without any other external equipment and takes only seconds to perform. The paediatric assessment triangle was established to enable the provider to understand the condition of the child based on the components which are the present, work of breathing and the circulation to the skin. The action plan for the family after Joe’s tonsillectomy surgery is to educate the family member to not give Joe any blood-thinning medication which includes aspirin and ibuprofen.
References:
Hahn, J., Barth, I., Wigand, M. C., Mayer, B., Hoffmann, T. K., & Greve, J. (2021). The Surgical Treatment of Peritonsillar Abscess: A Retrospective Analysis in 584 Patients. The Laryngoscope, 131(12), 2706-2712. https://doi.org/10.1002/lary.29677
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Kanaem AL-Ibady, Q. A. N. A., Mustafa Alani, A. A., & Hashem Icheeid, W. A. (2019). Isolation and Identification of Streptococcus pyogenes from Patients with Tonsillitis in Baghdad Province. Indian Journal of Public Health Research & Development, 10(5). https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09760245&AN=137482849&h=d%2FbSVKtLG3fdL1yOioPrvQIZhNwRLbkyF2R1NFAR7jQTH%2BXyZdspLPNjJTBd4hLo8vpaGVL46st4qzmOwfROCg%3D%3D&crl=c
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