Nursing Diagnosis and Nursing Intervention

Nursing Interventions for Acute Tonsillitis

Acute tonsillitis is an inflammation of the tonsils is still mild. Inflammation of the tonsils in children is almost always involve the surrounding organs so that the infection of the pharynx is usually also the tonsils, so called as tonsillopharyngitis.

Signs and symptoms of Acute Tonsillitis are:
  • Sore throat
  • Pain swallow
  • Difficulty in swallowing
  • Fever
  • Nausea
  • Anorexia
  • Swollen neck lymph nodes
  • Pharyngeal hyperemia
  • Pharyngeal edema
  • Enlarged tonsils
  • Tonsil hyperemia
  • Halitosis
  • Otalgia (ear pain)
  • Malaise

Nursing Interventions for Acute Tonsillitis

1. Hyperthermia related to inflammatory processes in the tonsils

  • Monitor your child's temperature (degrees and patterns), note the presence of shivering.
  • Monitor the temperature of the environment.
  • Limit the use of linen, clothing worn clients.
  • Give warm compresses.
  • Give plenty of fluids (1500 - 2000 cc / day).
  • Collaboration of antipyretics.

2. Acute pain related to swelling of the tonsils

  • Monitor the client's pain (scale, intensity, depth, frequency).
  • Assess vital signs.
  • Provide a comfortable position.
  • Give relaxation techniques with a long deep breath through your nose and release it slowly through your mouth.
  • Give a distraction technique to distract the child.
  • Collaboration of analgesics.

3. Imbalanced Nutrition: less than body requirements related to related to the existence of anorexia

  • Assess conjungtiva, sclera, skin turgor.
  • Weigh weight each day.
  • Provide food in a warm state.
  • Provide food in small portions but often serve food in the form of interest.
  • Increase comfort when eating environment.
  • Collaboration of appetite enhancer vitamins.

4. Activity intolerance related to weakness

  • Assess the client's ability to perform activities.
  • Observation of fatigue in the activity.
  • Monitor vital signs before, during and after the activity.
  • Provide a quiet environment.
  • Increase activity as tolerated clients.

5. Disturbed Sensory Perception: hearing related to obstruction

  • Review the client's hearing loss.
  • Do ear irrigation.
  • Speak clearly and slowly.
  • Use the white board / paper to communicate if there is difficulty in communicating.
  • Collaboration audiometric examination.
  • Collaboration of ear drops.

Nursing Diagnosis

Nursing Diagnosis


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