ADENOIDITIS-It is the inflammation of the adenoids. It is associated with tonsillitis.

 

ADENOIDITIS

 

It is the inflammation of the adenoids. It is associated with tonsillitis.

 

Adenoids is the nasopharyngeal mass of lymphoid tissue situated on its posterior superior wall. Usually, the term is applied to enlarge hypertrophied. Nasopharyngeal tonsils due to repeated upper respiratory tract infection.

 

Clinical Manifestation:

 

The adenoid hypertrophy produces its effects by different ways.

 

1.      Features due to nasal obstruction

2.      Features due to Eustachian tube blockage.

3.      Features due to mouth breathing.

4.      General manifestation.

 

 

1)      Features due to nasal obstruction.

 

·         The child becomes a mouth breather.

·         There is nasal discharge and evidence of sinusitis.

·         The Child snores at night or has noisy breathing.

 

2)      Features due to Eustachian tube blockage.

 

·         There is earache.

·         There may be deafness and evidence of secondary otitis media in many cases.

 

 

3)      Features due to mouth breathing.

 

·         The child has difficulty in feeding.

·         There is dribbling of the saliva.

·         There is chronic irritation of throat & voice may be altered due to breathing  of impure air.

·         Retracted upper lip and protruding teeth.

 

 

4)      General manifestation.

 

·         The child  has pinched nose.

·         The child have low nutrition level and get diarrhoea frequently.

·         The chest is pigeon shaped and the abdomen is protuberant.

·         Earache.

·         Ears discharge.

·         Bronchitis.

·         Foul smelling breathing.

·         Noisy respiration.

·         Hearing loss etc.

 

Etiology:

 

 Associated with tonsillitis

·         Nasal obstruction

·         Otitis media

·         Mastoiditis

 

Incidence:

    

Usually in children between 3 to 6 years of age

·         History collection

·         Physical examination

·         Culture of tonsilar site to determine the presence of bacterial infection

·         Audio metric examination

 

Management

 

Surgical treatment :

 

·         In case where features of adenoid hypertrophy are present, surgical removal i.e. Adenoidectomy is indicated.

·         Following removal of the adenoids regular nasal breathing exercise is to be carried out.

 

Conservative Treatment:

 

·         Simple nasal breathing exercise.

·         Should take fresh air.

·         Should take nutritious diet.

·         Control of nasal infection often help.

·         Nasal decongestants and antihistamine syrups are helpful for chronic nasal obstruction.

 

Complication:

 

·         Hemorrhage

·         Eustachian tube injury and stenosis

·         Otitis media

·         Incomplete removal and recurrence

 

 

NURSING MANAGEMENT

 

Nursing Diagnosis:

 

1)      Ineffective airway clearance related to excessive secretion and inflammations.

 

·         Assess the airway pattern.

·         Keep the secretion moist so that they can be easily expectorated.

·         Increased fluid intake helps thin the mucus.

·         Humidifying and environment with room vaporizers.

·         Inhaling the steam also loosens secretion and reduces inflammation of the mucous membrane.

·         Topical or systemic medication help to relieve nasal or throat congestion.

 

Nursing Diagnosis : Pain related to upper airway irritation secondary to an infection.

 

·         Assess the severity of pain.

·         The nurse encourages the patient to take analgesics such as acetaminophen with codeine as prescribed.

·         Use topical anesthetics for symptomatic relief of herpes simplex blisters and sore throat.

·         Hot packs and warm water gargles or irrigation to relieve the pain of a sore throat.

·         The nurse instructs the patients in general hygiene techniques to prevent the spread of infection.

·         For postoperative care following adenoidectomy an ice collar may reduce swelling and decrease bleeding.

 

Nursing Diagnosis: impaired verbal communication related to upper airway irritation.

 Secondary to infection or swelling.

 

·         Asses the level of communication.

·         The nurse should adverse the patient to communicate in writing as possible.

·         Do not provide additional strain on vocal cord after surgery.

·         Try to speak slowly and slowly.

 

Nursing Diagnosis: Knowledge deficit regarding prevention of upper respiratory infection treatment, procedure or post-operative care surgical.

 

·          Assess the level of knowledge of the patient.

·         The nurse advises the patient to minimize the infection and give knowledge that how they are transmitted.

·         The Nurse advises to use hygienic techniques.

·         Advise the patient to take over doses.

·         Advise the patient to take medication in time as prescribed.

·         Advise the patient to take nutritious and fresh diet.

·         Advise patient not to be keep incisional area wet keep it dry except medication.

·         Teach the patient to visit the physician time to time as prescribed.

·         Advise to use slowly nasal breathing exercise

·         Teach the patient about causes and pathology of the diseases.  

·         Advise to take more plenty of liquor diet as fruit juices etc.

 

Home care Management Adenoids:

 

·         Regular nasal breathing exercise is to be continued.

·         Take fresh air.

·         Nutritious diet to be given.

·         Nasal infection should be avoided.