WAYS ON HOW TO CARE A TONSILLITIS AND COMMON COLD PATIENT

NURSING CARE OF A PATIENT WITH TONSILLITIS AND COMMON COLD

Tonsillitis-Tonsillitis is an inflammation of the tonsils caused by infection and swelling of the
tonsils.
- Tonsils are oval-shaped masses of lymph gland tissue located on both sides of the
back of the throat.
- Most cases of tonsillitis are caused by viruses, which cannot be treated with
antibiotics

 Causes of Tonsillitis
* Tonsillitis is caused by:

1.  Viruses (the leading cause)
2.  Bacteria (mostly streptococcal).
3.  Malnutrition (especially vitamin deficiency) is a predisposing factor.

 Signs and Symptoms of Tonsillitis

•  The signs and symptoms of tonsillitis are as follows: 

1.   Difficulty and pain with swallowing 
2.  Throat pain and can be mild to severe 
3. Headache (occasionally) 
4.  Ear pain (occasionally) 
5.  Cough (occasionally) 
6.  Vomiting and abdominal pain especially in children 
7.  Fever and chills over 38 degrees Celsius or more 
8.  Red and swollen tonsils, often with exudate 
9.  Swollen and tender lymph glands on either side of the jaw 
10.  Negative response to eat in young children (loss of appetite) 
11.  Change in sound of the patient’s voice, i.e., muffled 
12.  Accurate diagnosis of the cause of tonsillitis requires a throat culture, however, clinical
    signs may be helpeful

            - Viral tonsillitis is commonly associated with runny nose, cough and conjunctivitis
           - Bacterial infections are commonly associated with fever, swollen nodes, headache and
              abdominal pain without runny nose, cough or conjunctivitis
          - NOTE: It is important to distinguish viral from bacterial infection so that antibiotics
                    will not be prescribed unless necessary.


 


Transmission of Tonsillitis
Tonsillitis is transmitted by

1.  Airborne particles from one person to another by coughing and sneezing. 
2.  Contaminated hand
3.   Sharing eating and drinking utensil or other objects.
   

NOTE: Patients with bacterial tonsillitis are usually no longer contagious 24 hours after
beginning a course of antibiotics.
Step 6: Treatment, Nursing Care of the Patient with Tonsillitis (25 minutes)
Management of tonsillitis is consistent with general care of respiratory disorders.
      4. Specific management includes:
            - Keep the patient comfortable while the illness runs its course by:
      5. Mouth gargles with warm salt water or Potassium Permanent
      6. Analgesics like Paracetamol.
      7. Warm tea can also be soothing.
      8. Penicillin or other antibiotics as per prescription. An injection of crystalline
           penicillin (X-pen) may be most effective in treating the infection.
       9. Maintain warmth to the child.
            - Administer oral antibiotic if prescribed and educate patient that it must be taken for
                 the full course of treatment, usually 10 to 14 days, even if the symptoms are no longer
                        present.
              - If the child has several episodes of severe tonsillitis, the doctor may recommend a
               tonsillectomy, which is the surgical removal of the tonsils.
              - Reassure the patients and family members about his condition.
              - Educate family on ways to prevent transmission to other family members
             - Educate the patients and family members about the importance of balanced diet.
             - If tonsillectomy is indicated pre-operative nursing roles should be assumed by nurse
             - Educate the patient and family member about causes of Tonsillitis.

 Prognosis
    - Tonsillitis usually resolves within a few days with rest and supportive care.
    - Treating the symptoms of sore throat and fever will make the child more comfortable.
    - A persistent sore throat lead to more serious conditions such as pneumonia or an
           abscess behind the tonsil (a peritonsillar abscess).
 
 Complications of Tonsillitis

•  Tonsillitis if not treated properly may complicate to other medical conditions such as:

1.  Rheumatic fever 
2.  Kidney inflammation (glomerulonephritis) 
3.  Abscesses (para-tonsillar or retropharyngeal) 
4.  Pneumonia 
5.  Infection to adjacent organs e.g. ears, mastoid 
6. Obstructive sleep apnea especially in children 
7.  Respiratory obstruction
   

 Definition of Common Cold  

•  Common cold is a contagious, self-limited viral upper respiratory tract infection. 
•  The common cold is also known as nasopharyngitis, acute viral rhinopharyngitis, or acute
  coryza
•   The common cold is the most frequent infectious disease in humans with the average
  adult contracting two to four infections a year and children typically contracting 5-6 colds
  a year. 
•  The typical cold last 7-10 days.
  

 Causes of Common Cold

 The common cold is a viral infection of the upper respiratory system caused by a variety of
common viruses including

1.   Rhinoviruses 
2. Corona viruses 
3.  Adenovirus 
4.  Respiratory syncytial virus (RSV) 
5.  Para influenza virus 
6.  Most types of cold viruses have many subtypes
   

 Signs and Symptoms
The symptoms of the common cold typically begin two to three days after acquiring the
infection (incubation period). They include:

1.   Cough 
2.  Sore throat 
3.  Nasal congestion 
4.  Runny nose 
5.  Sneezine
6.   Nasal stuffiness or drainage 
7.  Hoarseness of voice 
8.  Sometimes conjunctivitis (pink eye) 
9.  Muscle aches 
10.  Fatigue
11.   Headaches 
12. Shivering 
13.  Loss of appetite 
14.  Fever

  Transmission of Common Cold
The common cold is spread either by:

•  Inhaling the airborne virus after individuals sneeze or cough 
•  Direct contact with infected secretions from contaminated surfaces
  

       - A cold virus can live on objects such as pens, books, telephones, computer keyboards,
             and cups for about 18 hours and can thus be acquired from contact with these objects

•  The cold viruses can be contracted in a variety of settings (such as day care centers,schools, work places, overcrowded areas) and carried back to the home where it can
  spread from one family member to another. 
•  Malnutrition weakens the immune system and predisposes to frequent and prolonged
  colds.
  

 Treatment and Nursing Care of the Patient with Common Cold 

•  There are currently no medications or herbal remedies which have been conclusively demonstrated to shorten the duration of infection in all people with cold symptoms. 
•  Treatment comprises symptomatic support usually via:
  

           - Analgesics (e.g. paracetamol or ibuprofen) for fever, headache, sore muscles, and sore throat
           - First generation antihistamine to relieve runny nose
            - Decongestant nasal spray can reduce the symptoms of runny nose
            - Give plenty of drinking fluids to maintain hydration,
             - Gargles with warm salt water,

•  Other management as in general respiratory disorders

: Prevention of Common Cold
The best prevention for the common cold includes:

1.  Staying away from people who are infected, and places where infected individuals havebeen.
    
2.  Regular hand washing is recommended to reduce transmission of cold viruses and other
   pathogens via direct contact. 
3.  Avoid touching nose or eyes with hands. 
4.  Cleaning contaminated surfaces such as cup handles with a mixed alcohol/phenol
   disinfectan
5.   Avoid exposure to cold temperatures and wet weather
   

Summary 

•  Tonsils are part of immune system that protects and helps the body to fight and prevent infections
•   Children with bacterial tonsillitis are usually no longer contagious 24 hours after
  beginning a course of antibiotics. 
•  Most cases of tonsillitis are caused by viruses, which cannot be treated with antibiotics.
   
•  Common cold is a self-limited contagious illness that can be caused by a number of
  different types of viruses. 
•  A cold virus can live on objects such as pens, books, telephones, computer keyboards,
  and cups for several hours and can thus be acquired from contact with these objects.
   
•  One of the treatment of common cold is taking plenty of drinking fluids to maintain
  hydration 
•  Staying away from people who are infected, and places where infected individuals have
  been can prevent the spread of common cold to others

PREVENTION AND CONTROL OF DIARRHOEA IN ADULTS AND UNDER-5

    PREVENTION AND CONTROL OF DIARRHOEA IN ADULTS AND UNDER-5


    Definition of Diarrhoea

•   Diarrhoea is passage of loose or liquid stools for three or  more times per day (or more frequent passage than is normal for the individual).

•   Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by bacterial, viral or parasitic organisms.

   Causes of Diarrhoea in Adult and Under-Fives

•  The most common cause of diarrhoea is an infection of the intestines due to a virus (Rota virus)
•   Other causes are bacteria, or parasite
•  Diarrhoea usually occurs when fluid cannot be absorbed from the contents of bowel, or when extra fluid is secreted into bowel, which will causing watering stool
•   Diarrhoea can sometimes be a side effect of a medication, including

                      o antibiotics
                      o antacid medicines that contain magnesium
                      o some chemotherapy medicines
                      o non-steroidal anti-inflammatory drugs (NSAIDs)
                      o selective serotonin reuptake inhibitors (SSRIs)
                      o statins (cholesterol-lowering medicines)
                      o laxatives (medicine used to help empty your bowels

   Signs and Symptoms of Diarrhoea in Adult and under Five

•   Patients with diarrhoea may present with the following signs and symptoms:

                       o Nausea and vomiting
                       o Headache
                       o Loss of appetite
                       o Passing frequent loose and/or watery stools
                       o Abdominal cramps
                       o Abdominal pain
                       o Low grade fever
                       o Lightheadedness or dizziness
                              - From dehydration
                       o The excessive loss of water in stool.
                               -This can lead to dehydration

    Management of Diarrhoea in Adult and Under Five

•  Children should be breastfeed frequently and longer throughout the attack of diarrhoea
•  To prevent malnutrition and dehydration)
•  The provision of oral fluid or ORS will decrease the risk of dehydration and replace the lost minerals
•  The patient with diarrhoea should be taken to the a nearby health facility
• Treatment of diarrhoea will depend on the cause
• Correct assessment, treatment and continued feeding at the health facility level

   Preventive and Control Measure of Diarrhoea

•   Prevention of diarrhoea can be managed by the following measures:

                      o Washing hand after visiting the toilet and before eating or prepare a food
                      o Cleaning all equipments and utensils before serving meal and after eating

•   keep it in the clean container after cleaning

                      o Improving sanitation

•   By cleaning the environment and disposing off all the wastes.

                     o Cover pits latrine

•   to prevent transmission of diarrhoea

                    o Do not drink or eat raw foods or unpasteurized milk.
                    o Washing raw fruits and vegetables thoroughly before eating.
                    o Cooking chicken eggs thoroughly (until the yolk is firm).

       Summary

•    Diarrhoea is the passage of loose or liquid stools for three times or more per day (or more frequent passage than is normal for the individual)
• Diarrhoea is usually a symptom of an infection in the intestinal tract, which can be caused by a variety of bacterial, viral and parasitic organisms
• Signs and symptoms associated with diarrhoea may include nausea and vomiting, headache, loss of appetite, frequent loose /watery stool and abdominal cramps