A 7 year old has experienced recurrent tonsillitis for the past year. He is scheduled for...

A 7 year old has experienced recurrent tonsillitis for the past year. He is scheduled for a tonsillectomy later in the day. You are assessing the child to obtain a baseline and is providing pre-operative teaching and a tour of the recovery area and day surgery area to the child and parents.

1. What health history is important to elicit from the family?

2. What content should the nurse emphasize in pre-operative teaching directed to the parents?

3. What content should the nurse emphasize in pre-operative teaching directed to the child?

4. What physical assessments of the child are indicated?

Expert Solution

1. As the child is scheduled for a tonsillectomy later in the day, the health history of the patient is very important to be taken before the surgery. The following points are important to be elicited from the parents.

Ask the parents if there is any history of medical conditions for the child
Any past surgical history
If the child is taking regular medications daily
Is the child allergic to any medications or any food items.
Does the child had any symptoms of flu or fever in the past 1 week

2. Pre- operative teaching to the parents.

Tonsillectomy is the removalof the tonsils. This surgery is done under general anesthesia. The pre- operative teaching of the patents should include the following points.

Explain to the parents what is the procedure and the approximate time taken so as to reduce the stress and anxiety of the parents.
Explain the importance of keeping their chid Nil by mouth for almost 8 hours. If the child has tken anything sholuld be informed to the Doctor so as to avoid complication with anesthesia. If the Child has eaten or taken any fluids can cause vomiting during anesthesia and also can cause aspiration.
No medications especially NSAIDs should be taken on the day of surgery.
The child may have swallowing difficulty on the first day of the surgery which will resolve sooon.
Pain medications will be given after the procedure is done.

3) As the child is 7 years old the following points to be explained to the child.

Explain to the patient that the procedure is the removal of the tonsils,explaination can be done by showing pictures so as to reduce the stress of the patient.
Inform the patient the importance of keeping Nil by mouth.
Inform the patient that the procedure is done under anesthesia hence no pain will be known during the procedure.
After the procedure pain medication will be given to reduce the pain
Inform that initial day of surgery there wil be swallowing difficulty but it will be resolved soon.

4) Physical Assessment of the child required are

Height and weight of the patient, weight is very important as the anesthesia medication are calculated on weight basis.
Vital signs should be recorded as to keep a tract of fever or any abnormal vital signs.
Auscultation of the chest to know if there is any wheezing or any abnormal sounds noticed which should be informed
Cough, fever or runny nose to be checked and informed.

All these factors should be noticed as surgery can be postponded if the child any fever or chest infections.

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