Nursing Care Plan

CUES AND CLUES NURSNG

DAGNOSS
SCENTFC
RATONALE
EXPECTED CLENT
BEHAVOR/OUTCOME
NURSNG
NTERVENTON
SCENTFC
RATONALE
EVALUATON

Objective:
-Reddened tonsils
-Vital signs taken as
follows:
T= 37.3
PR= 108
RR= 25

Subjective:
- "nahihirapan nga
siya kumain.masakit
daw aang lalamunan
niya. As verbalized
by the patient's
mother
- sore throat

mpaired oral
mucous membrane
related to infectious
process as
evidenced by
inflamed tonsils.

Tonsillitis is an
inflammation of the
tonsils caused by an
infection. n
tonsillitis, the tonsils
are enlarged, red,
and often coated
(either partly or
entirely) by
a substance that is
yellow, gray, or
white. Tonsillitis
usually occurs as
part of pharyngitis
(throat infection).
Tonsillitis usually
begins with sudden
sore throat and
painful swallowing.

Sometimes,
tonsillitis reoccurs,
and may cause
difficulty breathing. f
this occurs, the
doctor may
recommend taking
them out. This
procedure of

After 5 hours of nursing
intervention, patient's
mother will verbalize
understanding of the
etiology and
management of
tonsillitis of her child.

After applying the
health teachings given
to the mother, patient's
condition will improve
and recurrence of the
infection will be
avoided.

-Advice mother to
continue with the
antibiotics as
prescribed by the
doctor even if
symptoms subside.

- Advise mother to
avoid giving sweets
and cold beverage
to the patient.

-Encourage mother
to do tepid sponge
bath in case fever
persists.

-Teach mother how
to properly suction
the patient of
secretions.



- Promote oral fluid
intake




- To completely
destroy the bacteria.
This also prevents
the resistance of the
bacteria from the
antibiotic.

-Bacteria proliferate
faster in sweet
environment.


-Tepid sponge bath
decreases the
body's temperature
through conduction.

-Proper suctioning
will relieve the
patient of difficulty
breathing as
secretions may
obstruct the airway.

-Without proper
nutrition and
hydration the oral
mucosa is more
vulnerable to

After 5 hours of
nursing intervention,
patient's mother was
able to verbalize
understanding of the
etiology and
management of the
tonsillitis.
removing tonsils
from the throat is
called a
tonsillectomy.




-Advise mother to
make patient gargle
with a solution of
warm water and salt
damage. This will
also prevent
dehydration

-This relieves the
patient's sore throat
Although this is only
short-lived.