TRACE COLLEGE

Traceville Subdivision, El Danda Street, Los Baños, Laguna

COLLEGE OF NURSING
Bachelor of Science in Nursing

In partial fulfillment of the course requirement in

Nursing Care Management 102 with RLE

NURSING CASE STUDY

Acute Tonsillopharyngitis

Submitted by:

Joel Ian D. Espenilla

BSNII – 1N

Date Submitted:
February 11, 2010

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means. Please obtain permission from the College of Nursing – TRACE College.
 CHAPTER 1
INTRODUCTION

Last February 5, 2010, a group of students with nine members were assigned to Mrs.
Julie Anne Paullete A. Onte at Los Baños Doctor’s Hospital and Medical Center to complete
their affiliation and to gain lots of new knowledge, and develop their skills and passion on the
field of nursing.

Each members of the group were required to submit an individual nursing case study.
We are told that we will be assigned on the 3rd floor medical ward and will handle all patients
hospitalized on that ward.

What interests me to take Ms. JCBP’s case to be studied is that with all of the patients
that I had handled, hers is further the most complicated case. I had handled mild cases and
they are all on discharged.

Tonsillopharyngitis is an acute infection of the pharynx or the palatine tonsils or both.

Symptoms may include sore throat, dysphagia, cervical lymphadenopathy, and fever.
Diagnosis is clinical, supplemented by culture or swoft antigen test. Treatment is dependent
on symptoms.

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 CHAPTER 2
OBJECTIVES

General Objectives:

My general objective is to understand what Acute Tonsillopharyngitis is.

Specific Objectives:

Specifically:
1.) To know what causes to have Acute Tonsillopharyngitis.
2.) To know the anatomy and physiology of the body organ involved in Acute
Tonsillopharyngitis.
3.) To understand the pathophysiology of Acute Tonsillopharyngitis.
4.) To relate my patient chief complaint on her condition having Acute Tonsillopharyngitis.
5.) To improve myself on formulating Nursing Care Plans.
6.) To relate the medications and medical procedures done to Ms. RR on her condition of
having Acute Tonsillopharyngitis.

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 CHAPTER 3
HEALTH HERTORY
i. PATIENT’S DATA

Patient's Name: “Ms. JCBP” Hospital Case No.: 0067310

Address: Jubileeville, Masaya, Bay, Laguna
Birth Date: 06/29/91 Placeof Birth: San Pablo City, Laguna, Ph
Age: 1Y7M6D Insurance: n/a
Sex: Female Date & Time Admitted: 02-03-2010/11:50AM
Ordinal Rank (if pedia patient): n/a Ward/Room No./Bed No.: Rm. 306A
Nationality: Filipino Inclusive Date of Confinement: ---
Civil Status: Single Discaharge Date&Time: ---
Religion: Catholic Attending Physician: Dr. M, MD
Occupation: Student Educational Background: 4th yr. College

Payment Source for Discharges:

Self/Family: Mrs. CBP Employer/Union (give name):
Public Agency (give name): Others (pls. specify):
Private Insurance (pls. specify name of insurance company):

Admitted per: Ambulatory: Stretcher: Wheelchair: 

Level of Consciousness upon Admission:


Alert:  
Oriented: Responds to Verbal: Unresponsive:
*
Drowsy: Disoriented: Responds to Pain: Confused:
Lethargic: Asleep: Easily Aroused:

Chief Complaint/s:
Sore throat

Impression/ Admitting Diagnosis:

Acute Tonsillopharyngitis

Final Diagnosis:
Acute Tonsillopharyngitis

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ii. PAST HEALTH HERTORY

Ms. JCBP verbalized that she had not been hospitalized in her life. She completed her
vaccines but cannot enumerate the vaccines. She had chickenpox when she was 8 years
old.

iii. PRESENT HEALTH HERTORY

Nine days prior to admission, she had experienced cough and colds. Two days prior
to admission, she had an on and off fever. She also experienced sore throat.

iv. ADMISSION HERTORY

The patient was admitted last February 3, 2010 around 11:50am with the chief
complaint of sore throat. She was admitted under the service of Dr. M, MD with the admitting
impression of Acute Tonsillopharyngitis. Consent for admission was secured. The doctor
ordered administration of IVF D5LR 1L x 80. the doctor also ordered to monitor her VS q40
and record it. Her diet was DAT. The doctor also ordered the lab results of CBC and
urinalysis. With the administration of the following drugs: Biogesic 500g/tab q40 pn for fever;
Arcoxia 90mg 1 tab OD; Difflam gargle TID; Zinacef 750mg IV q80 ANST(-).

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v. GENOGRAM

CS
SSB
SPDP DP ASB
80y/
82y/o 78y/ 79y/o
o
o

DP AR
HPL
E BRDP BP AJSB
52y/
48y/ 40y/o 41y/ 35y/o
o
o o

JCB
BJBP P DBBP
Legend: 20y/o 18y/ 10y/o
o

- heart attack
- asthma
- diabetes

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 CHAPTER 4
PHYSICAL ASSESSMENT
I General Survey

Patient’s mobility was not limited, with slow and she has a coherent speech.
She is conscious but looks drowsy and weak on the first day of my care. Dress appropriately
on the condition of her room (specifically the room temperature):

Vital Signs results are:

• Temperature: 36.6 oC
• Pulse Rate: 85 bpm
• Respiratory Rate: 24 cpm
• Blood Pressure: 100/60 mmHg

II Skin, Hair and Nails

The color of her hair is black. Her skin is smooth, intact and warm to touch without any
rashes, bruises nor cuts. Her nails are intact, cut, clean and with three seconds capillary
perfusion.

III Head, Neck and Lymph Nodes

Neck and lymph nodes palpation is not done.

IV Nose and Sinuses

She had signs of colds.

V Mouth and Throat

Lips look pale in color. Patient verbalized itchiness on throat and difficulty on clearing
her throat. Teeth are clean with whitish color.

VI Eyes

Patient has normal eyesight of 20/20. she doesn’t wear any contact lens nor glasses.
Her reaction to light is normal.

VII Ears

Assessment not done.

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 VIII Respiratory System

Upon auscultation, I heard a wheezing breath sound. Percussion was not done. Use
of accessory muscles while coughing was noted. The patient verbalized that she sometimes
feels difficulty on breathing.

IX Cardiovascular System

She is not hypertensive with BP of 100/60 mmHg during our shift. The patient doesn’t
feel any chest pain during my shift.

X Breasts

Assessment not done.

XI Gastro-Intestinal System

Assesment not done.

XII Urinary System

Patient’s urinated twice. Amount of urine depends on the amount of fluid intake.

XIII Reproductive System

Assessment not done.

XIV Nervous System

Assessment not done.

XV Musculoskeletal System

Patient is but shows weakness on doing activities like walking and changing positions.

XVI Endocrine System

Assessment not done.

GORDON’S FUNCTIONAL HEALTH PATTERN

A. HEALTH PERCEPTION – HEALTH MANAGEMENT PATTERN

Whenever she is sick she buy OTC drugs, then if symptoms persists, that’s the time
she’ll go to her doctor and have check-up.

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 B. NUTRITIONAL – METABOLIC PATTERN

She eats whatever she wants to eat. She loves to eat fatty foods. She verbalized that
she’s not eating street foods.

C. ELIMINATION PATTERN

As she verbalized, she defecated normally and she also urinated normally.

D. ACTIVITY – EXERCISE PATTERN

As a student, she always go to school riding jeepneys. She seldom exercise. her
everyday walking is her means of exercise.

E. SLEEP – REST PATTERN

On the past few days, she had few amount of sleep hours. She is catching thesis and
project on deadline.

F. COGNITIVE – PERCEPTUAL PATTERN

She is coherent and answers my questions directly.

G. SELF– PERCEPTION PATTERN/SELF – CONCEPT PATTERN

The patient is conscious but shows loneliness and boredom.

H. ROLE – RELATIONSHIP PATTERN

She verbalized that all the members of the family were close with each other. And
she’s happy with how her relationship with her family goes.

I. SEXUALLY – REPRODUCTIVE PATTERN

She refused to answer questions in this pattern.

J. COPING STRESS TOLERANCE PATTERN

Whenever she’s bored or sad, she takes rest and sleeps. She is not that fond of
watching TV.

K. VALUES/BELIEF PATTERN

Their whole family religion is Catholic. They do not believe in hilot and faith healers.

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 CHAPTER 5
DEFINITION OF COMPLETE MEDICAL DIAGNOSIS

Acute Tonsillopharyngitis is an acute infection of the pharynx or palatine tonsils or

both. Symptoms may include sore throat, dysphagia, cervical lymphadenopathy, and fever.
Diagnosis is clinical, supplemented by culture or swift antigen test. Treatment is dependent
on symptoms and, within the case of GABHS, involves antibiotics.

Tonsillopharyngitis is usually viral, most regularly caused by the adjectives cold

viruses (adenovirus, rhinovirus, influenza, coronavirus, respiratory syncytial virus), but
occasionally by Epstein-Barr virus, herpes simplex virus, cytomegalovirus, or HIV. In in the
region of 30% of cases, the cause is bacterial. Group A β-hemolytic streptococcus (GABHS)
is most adjectives (see Gram-Positive Cocci: Streptococcal Diseases), but Staphylococcus
aureus, Streptococcus pneumoniae, Mycoplasma pneumoniae, and Chlamydia pneumoniae
are sometimes involved. Rare causes include pertussis, Fusobacterium, diphtheria, syphilis,
and gonorrhea.

Tonsillopharyngitis of adjectives varieties constitutes nearly 15% of all department

visits to primary supervision physicians. GABHS occurs most commonly between ages 5 and
15 and is singular before age 3.

Symptoms and Signs

Pain next to swallowing is the hallmark and is often referred to the ears. Very
youthful children who are not able to complain of sore throat habitually refuse to guzzle. High
fever, malaise, headache, and GI upset are adjectives, as are halitosis and a muffled voice.
A scarlatiniform or nonspecific rash may also be present. The tonsils are swollen and red
and recurrently have purulent exudates. Tender cervical lymphadenopathy may be present.
Fever, adenopathy, palatal petechiae, and exudates are somewhat more adjectives with
GABHS than near viral tonsillopharyngitis, but there is much overlap. GABHS usually
resolves inside 7 days. Untreated GABHS may lead to local suppurative complications (eg,
peritonsillar abscess or cellulitis) and sometimes to rheumatic disorientation or
glomerulonephritis.

Diagnosis

Pharyngitis itself is easily traditional clinically. However, its cause is not.

Rhinorrhea and cough usually indicate a viral explanation. Infectious mononucleosis is
suggested by posterior cervical or generalized adenopathy, hepatosplenomegaly, fatigue,
and malaise for > 1 wk; a full neck near petechiae of the soft palate; and thick tonsillar
exudates. A dirty gray, gummy, tough membrane that bleeds if peeled away indicates
diphtheria .

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 CHAPTER 6
ANATOMY AND PHYSIOLOGY

The Upper Respiratory Tract and tonsil

The upper respiratory tract refers to the following parts of the respiratory system:

• nose and paranasal sinuses

• oral cavity (also part of the digestive system)
• throat
o pharynx
 nasopharynx
 oropharynx
 laryngopharynx
o larynx (The larynx can be considered part of the upper respiratory tract or the
lower respiratory tract depending on the source. Some specify that the glottis
(vocal cords) is the defining line between the upper and lower respiratory
tracts; others make the line at the cricoid cartilage.)

Unlike the trachea and bronchi, the upper airway is a collapsible, compliant tube. As
such, it has to be able to withstand suction pressures generated by the rhythmic contraction
of the diaphragm that sucks air into the lungs. This is accomplished by the rhythmic
contraction of upper airway muscles, such as the genioglossus (tongue) and the hyoid
muscles. In addition to rhythmic innervation from the respiratory center in the medulla
oblongata, the motoneurons controlling the muscles also receive tonic innervation that sets a
baseline level of stiffness and size.

The tonsils are areas of lymphoid tissue on either side of the throat. An infection of
the tonsils is called tonsillitis. Most commonly, the term "tonsils" refers to the palatine tonsils
that can be seen in the back of the throat.

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 CHAPTER 7
PATHOPHYSIOLOGY

VIRAL BACTERIAL FUNGAL MISCELLANEOUS

 Influenza  Streptococcus  Candida  Toxoplasma

 Para-influenza (Group A beta (parasite)

 Herpes simplex hemolytic)  Chlamydia

 Measles  Diphtheria

 Chickenpox  Gonococcus

 Cytomegalo-
virus
 Rhinovirus

Mild Infections:
• Discomfort in throat
• Malaise
• Low grade fever
• Congested pharynx but no lymphadenopathy.

Moderate to Severe Infections:

• Pain in throat
• Dysphagia
• Headache

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 CHAPTER 8
LABORATORY AND DIAGNOSTIC EXAMINATIONS

NURSING
DIAGNOSTIC
DATE ACTUAL CLINICAL SIGNIFICANCE CONSIDERATIONS
EXAMINATIONS WITH NORMAL FINDINGS
ORDERED RESULTS (RATIONALE) BEFORE AND AFTER
DEFINITIONS
THE PROCEDURES
Hemoglobin
• 13 – 18 gms
13.8 Within normal range
02/03/10
HEMATOLOGY/CBC – the Hematocrit
most commonly performed Within normal range
•40 - 54 vol % 43 %
blood test which is a basic RBC Count
evaluation of the cellular
• 4.5 – 5.5 M/ml
4.8 M/ml Within normal range
components of blood. 1. Instruct family
WBC Count about the requirements or
• 5,000-10,000 15,600/μl high instructions
cumm 2. Inform the
Differential WBC Count mother/family about the time
• Segmented period before the results will
Neutrophils: 88% high be available.
55 - 65% 3. Document
teachings. Include the
• Lymphocytes: 12% low client’s responses.
25 - 35%
• Monocytes:
---
3 - 7%
• Eosinophils: ---
0 - 5%
• Basophils:
---
0 - 3%

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02/03/10 Urinalysis – the chemical analysis of Appearance: Urinalysis Obtaining a clean catch
urine sample • Clear Clear To measure and detect urine sample:
Color: the level of a variety of The head of the man’s
• yellow Yellow substances in the urine. penis or opening of a
Odor : woman’s urethra is
• aromatic Not specified cleansed, usually with a
Transparency: small pad that contains an
turbid antiseptic substance.
Specific Gravity : A few drops of urine are
• 1.005 - 1.030 1.010
allowed to flow into the
Glucose : toilet washing out the
• negative Negative
urethra.
Casts : Urination is resumed and a
No albumin trace
• none sample is collected from the
WBC : stream into a sterile cup.
• 0-4 2 – 3/cast
Always wash your hands
RBC : before and after holding your
0-1
• <2 patient.

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 CHAPTER 9
MEDICAL MANAGEMENT
DOCTOR’S ORDER

Feb. 3, 2010
• Admit to ROC under Dr. M
• Secure consent pls.
• Inform BP once admitted
• Monitor OS CL (temp.) q shift (BP, RR, PR)
• DAT
• IVF D5LR; 1L x 8 hrs
• Dx – CBC w/ PH
• Urinalysis
• Refer accordingly
Dr. M

Feb 4, 2010 • Dx – Zinacef 750mg IVT q 8 ANST

• Biogesic 500mg PO q4 for fever
• Difflam gargle TID
• Arcoxia 90mg OD PO
• IVF D5NM; 1L x 8 hrs
• Refer accordingly
Dr. M

Feb. 5, 2010 • IVF D5NM; 1L x 8 hrs

• Px may go home
Dr. M

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 CHAPTER 10
NURSING CARE MANAGEMENT
NURSING CARE PLAN

Assessment Scientific Diagnosis Planning Nursing Rationale Evaluation

Rationale Intervention
02/04/10 Redness and Ineffective At the end of > Give due >Zertin is > the patient will
Cues: pain is caused Airway shift, the patient meds. as indicated to report that
S>”Masakit ang by the Clearance r/t will show signs ordered orally treat tonsillitis there is no
lalamunan ko,” inflammation of inflammation of of relief after a (Zertin and and Difflam more swelling
as verbalized the tonsil. tonsils satisfactory relief Difflam gargle) gargle is used and pain in her
O> received measure to temporarily neck. Upon
patient asleep relief the pain assessment,
lying in bed w/ in the throat the neck area
an IVF of D5LR > Assess > Signs of relief will have no
1L @ 100 cc lvl effectiveness of indicates tht redness. She
running at 31.25 Difflam gargle the drug is will also report
gtts/min to run after 30 mins. effective; no no signs of
for 8 hrs infusing change in coughing.
well @ the L condition
metacarpal vein indicates drug
> (+) redness is not effective
@ neck area > Render health >Hot and cold
>(+) pain and teaching to compress is
swelling @ neck patient: use of applied to the
area hot/cold swelling/painful
>(+) cough compress area to lessen
and colds methods to the pain
relieve pain

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 CHAPTER 11
DRUG STUDY
A. INTRAVENOUS THERAPY

Classification/ Mechanisms Adverse Reaction/

IV fluid Indications Nursing Responsibilities
Type Of Action Side Effects

D5NM Hypertonic Normosol-M and 5% Normosol-M and Reactions which Solutions containing sodium ions
Or Solution Dextrose Injection 5% Dextrose may occur because should be used with great care, if
Normosol- (Multiple Injection provides of the solution or at all, in patients with congestive
M in 5% Electrolytes and 5% water and the technique of heart failure, severe renal
Dextrose Dextrose Injection electrolytes (with administration insufficiency and in clinical states
Type 1, USP) is dextrose as a include febrile in which there exists edema with
indicated for readily available response, infection sodium retention.
parenteral source of at the site of Solutions which contain
maintenance of carbohydrate) for injection, venous potassium should be used with
routine daily fluid maintenance of thrombosis or great care, if at all, in patients with
and electrolyte daily fluid and phlebitis extending hyperkalemia, severe renal failure
requirements with electrolyte from the site of and in conditions in which
minimal requirements, plus injection, potassium retention is present.
carbohydrate minimal extravasation and In patients with diminished renal
calories from carbohydrate hypervolemia. function, administration of
dextrose. calories. If an adverse solutions containing sodium or
Magnesium in the reactiondoes occur, potassium ions may result in
formula may help to discontinue the sodium or potassium retention.
prevent iatrogenic infusion, evaluate Solutions containing acetate
magnesium the patient, institute should be used with great care in
deficiency in appropriate patients with metabolic or
patients receiving therapeutic respiratory alkalosis, and in those
prolonged countermeasures conditions in which there is an
parenteral therapy. and save the increased level or an impaired

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 remainder of the utilization of acetate, such as
fluid for examination severe hepatic insufficiency.
if deemed Administration of ther solution can
necessary. cause fluid and/or solute
overloading resulting in dilution of
serum electrolyte concentrations,
overhydration, congested states
or pulmonary edema. The risk of
dilutional states is inversely
proportional to the electrolyte
concentrations of administered
parenteral solutions. The risk of
solute overload causing
congested states with peripheral
and pulmonary edema is directly
proportional to the electrolyte
concentrations of such solutions.

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 Adverse
Classification/ Mechanisms
IV fluid Indications Reaction/ Nursing Responsibilities
Type Of Action
Side Effects

D5LRS Lactated Ringer’s Lactated Ringer’s Allergic reactions Lactated Ringer’s and 5%
Or and 5% Dextrose and 5% Dextrose or anaphylactoid Dextrose Injection, USP should
Lactated Injection, USP is Injection, USP has symptoms such be used with great care, if at all,
Ringer’s indicated as a value as a source as localized or in patients with congestive heart
Solution in source of water, of water, generalized failure, severe renal insufficiency,
5% electrolytes and electrolytes, and urticaria and and in clinical states in which
Dextrose calories or as an calories. It is pruritus; there exists edema with sodium
alkalinizing agent. capable of inducing periorbital, facial, retention.
diuresis depending and/or laryngeal Lactated Ringer’s and 5%
on the clinical edema, Dextrose Injection, USP should
condition of the coughing, be used with great care, if at all,
patient. sneezing, and/or in patients with hyperkalemia,
Lactated Ringer’s difficulty with severe renal failure, and in
and 5% Dextrose breathing have conditions in which potassium
Injection, USP been reported retention is present.
produces a during Lactated Ringer’s and 5%
metabolic administration of Dextrose Injection, USP should
alkalinizing effect. Lactated Ringer’s be used with great care in
Lactate ions are and 5% Dextrose patients with metabolic or
metabolized Injection, USP. respiratory alkalosis. The
ultimately to The reporting administration of lactate ions
carbon dioxide and frequency of should be done with great care in
water, which these signs and those conditions in which there is
requires the symptoms is an increased level or an impaired
consumption of higher in women utilization of these ions, such as
hydrogen cations. during severe hepatic insufficiency.
pregnancy. Lactated Ringer’s and 5%
Reactions which Dextrose Injection, USP should
may occur not be administered

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 because of the simultaneously with blood
solution or the through the same administration
technique of set because of the likelihood of
administration coagulation.
include febrile The intravenous administration of
response, Lactated Ringer’s and 5%
infection at the Dextrose Injection, USP can
site of injection, cause fluid and/or solute
venous overloading resulting in dilution of
thrombosis or serum electrolyte concentrations,
phlebitis overhydration, congested states,
extending from or pulmonary edema. The risk of
the site of dilutional states is inversely
injection, proportional to the electrolyte
extravasation, concentrations of the injection.
and The risk of solute overload
hypervolemia. causing congested states with
If an adverse peripheral and pulmonary edema
reaction does is directly proportional to the
occur, electrolyte concentrations of the
discontinue the injection.
infusion, evaluate In patients with diminished renal
the patient, function, administration of
institute Lactated Ringer’s and 5%
appropriate Dextrose Injection, USP may
therapeutic result in sodium or potassium
countermeasures retention.
, and save the Lactated Ringer’s and 5%
remainder of the Dextrose Injection, USP is not for
fluid for use in the treatment of lactic
examination if acidosis.
deemed
necessary.

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B. MEDICATIONS

Generic Indication Mechanisms Contraindication Adverse Effects Nurisng

Name Of Action Considerations
Paracetamol Fever Paracetamol has long • If the patient is • Skin rashes • Watch out for
been suspected of having allergic to and minor overdosage,
Brand Name: a similar mechanism of paracetamol or stomach and Paracetamol
Biogesic action to aspirin because any ingredient in intestinal causes
of the similarity in the product. disturbances hapatotoxicity
Dosage/Route/ structure. That is, it has • Avoid long- • Do not use
Frequency: been assumed that term use of with any other
500mg PO q4o paracetamol acts by paracetamol in medicine
reducing production of patients with containing
prostaglandins, which are anemia or with Paracetamol.
involved in the pain and heart, lung,
fever processes, by kidney, or liver • Do not use
inhibiting the disease. medicine if the
cyclooxygenase (COX) patient has liver
enzyme as aspirin does. disease and if
patient is taking
warfarin, a blood
thinning medicine.

Generic Name Indication Mechanisms of Action Contraindication Adverse Effects Nursing

Considerations

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Etoricoxib Relief of acute Arcoxia reduces pain Patient hypersensitive • feeling sick • Arcoxia can be
pain and inflammation by to drug and to (nausea), given to pregnant
Brand Name: blocking COX-2, an hypertensive patients. vomiting women during
Arcoxia enzyme in the body. Also contraindicated • heartburn, their late stages
to patients who will indigestion, pregnancy.
Dosage/Route/ undergone major uncomfortable • Do not
Frequency: surgery that may feeling or pain in administer if there
90mg PO OD increase risk of the stomach is an allergic
coronary artery • diarrhoea reaction to any
disease • swelling of other anti-
the legs, ankles inflammatory
or feet drugs.
• high blood • Do not
pressure administer if the
• dizziness patient has
• headache allergic reaction to
any other
substance such as
food preservative
or dyes.
• Inform the
physician if the
patient has a
history of stroke or
mini stroke

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 Generic Indication Mechanisms Contraindication Adverse Effects Nurisng
Name Of Action Considerations
Difflam Gargle Relief of painful Gives temporarily Patient hypersensitive Oral numbness, • Always
conditions of the relief to inflammation to dru. Also burning or stinging remind that the
Dosage/Route/ mouth & throat of tonsils and contraindicated to sensation, dryness drug used for
Frequency: including tonsillitis, pharynx patients with hepatic or or thirst, tingling, gargle purposes;
1 cup PO gargle sore throat, renal impzairment. warm feeling in watch if the
TID radiation mouth, altered patient drinks the
mucositis, sense of taste, medication.
aphthous ulcers, nausea, vomiting, • Must have
post-orosurgical & retching, GI special
periodontal disorders, consideration to
procedures. Helps dizziness, pregnant clients
to reduce the headache, and to clients
development of drowsiness. below 6 years old.
plaque & gingivitis • If sore throat
during the period is caused or
of treatment when complicated by a
the usual oral bacterial infection,
hygiene measures appropriate
are interrupted. bacterial therapy
should be
considered in the
addition to use
Difflam gargle.
Cefuroxime Injectable form is Inhibits cell-wall Hypersensitivity to Pseudomembranou Assess for previous
used for treatment synthesis, promoting cefuroxime, any s colitis, history of reactions
Brand Name: of serious osmotic instability; component. Or other hypersensi- to other
Zinacef infections of the usually bactericidal cephalosporin tivity, reactions, cephalosporin or
lower respiratory serum sickness, penicillin.
Dosage/route tracts. anaphylaxis
Frequency:
750mg IVT q8o
ANST

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TRACE College.
 CHAPTER 12
PROGNOSIS/EVALUATION

Criteria Poor Fair Good Justification

Duration of Illness Duration of illness is good because
 her illness heals.
Onset of Illness Onset of illness is fair because it is
 immediately attended.
Precipitating Factors Precipitating factors were fair because
 of her present living. Her status of
being a student may cause her
tonsillitis back.
Willingness to take medicines She is willing to take her medications
 and doesn’t have any difficulty on
swallowing tablets and capsules.
Compliance to treatment Compliance to treatment was good
regimen  because she is willing to do whatever
her doctor told him so.
Age Age as criteria is fair because she is
 not too old and not too young to
develop such illness.
Environment Environment as criteria is poor
 because she is exposed on pollutions
especially when traveling.
Family Support Family Support as criteria is good
 because there is always someone in
her family that stays with her at the
hospital.

Prognosis of the patient is good. She can overcome the disease if she knows how to prevent being exposed on its predisposing factors and
prevent being sick, especially acquiring cough and colds. Family Support is also a big help for her recovery.

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 CHAPTER 13
DISCHARGE PLAN

MEDICATION
• Difflam gargle TID until total relief.
EXERCISE
• Be sure to get enough rest and sleep on a daily basis.

TREATMENT
• If you do not smoke, don’t start.
• Avoid stress, fatigue, sudden changes in temperature and excessive alcohol intake, all of ther lowers resistance to
pneumonia.

HYGIENE
• Take bath daily.
• Promote frequent oral hygiene.

DIET
• Drink plenty of water (at least 8 glasses every day), especially during warm weather.
• Eat a healthy, balanced diet and take in a sufficient amount of non-alcoholic fluids each day.

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 BIBLIOGRAPHY

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Ther is a property of College of Nursing – TRACE College. No part of ther manuscript may be reproduced or transmitted in any form or by any means. Please obtain permission from the College of Nursing –
TRACE College.
Gupta, L.C.. Illustrated Nurses’ Dictionary (2nd Ed.). India. AITBS Publishers and Distributors. 2005.

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Wikipedia. (22 May 2008,). Intravenous Therapy. http://en.wikipedia.org/wiki/Intravenous_therapy

Ther is a property of College of Nursing – TRACE College. No part of ther manuscript may be reproduced or transmitted in any form or by any means. Please obtain permission from the College of Nursing –
TRACE College.