Page 1011 - Saunders Comprehensive Review For NCLEX-RN

of the tubes (tiny, white, spool-shaped
tubes).
IV. Tonsillitis and Adenoiditis
A. Description
1. Tonsillitis refers to inflammation and infection of the
tonsils, which is lymphoid tissue located in the
pharynx (Fig. 34-1).
2. Adenoiditis refers to inflammation and infection of the
adenoids (pharyngeal tonsils), located on the
posterior wall of the nasopharynx.
3. Enlarged tonsils and adenoids may lead to an
obstructive sleep apnea in children, manifested by
snoring and periods of sudden waking and
fragmented sleep; a polysomnography and referral to
ear, nose and throat specialist may be needed.
4. Can be the result of a viral, bacterial, or fungal
infection. Group A streptococcus (“strep throat”) is a
common bacterial infection of the oropharynx,
particularly in children, which can result in
streptococcal toxic shock syndrome. Mononucleosis is
another possible cause of tonsillitis and adenoiditis.
5. Tonsillectomy (surgical removal of the tonsils) and
adenoidectomy (surgical removal of the adenoids)
may be necessary depending on the number of
infections per year as well as signs of obstructive
respiratory disturbance.
B. Assessment
1. Persistent or recurrent sore throat
2. Enlarged, bright red tonsils that may be covered with
white exudate
3. Difficulty in swallowing
4. Mouth breathing and an unpleasant mouth odor
5. Fever
6. Cough
7. Enlarged adenoids may cause nasal quality of speech,
mouth breathing, hearing difficulty, snoring, or
obstructive sleep apnea.
C. Preoperative interventions
1. Assess for signs of active infection.
2. Assess bleeding and clotting studies, because the
throat is vascular.
3. Assess for any loose teeth to decrease the risk of
aspiration during surgery.
4. Prepare the child for a sore throat postoperatively, and
inform the child that she or he will need to drink
liquids.
D. Interventions postoperatively

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