Download PHARYNGITIS

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ACUTE PHARYNGITIS
Definition of Acute pharyngitis :Acute pharyngitis is a sudden painful inflammation or
infection in the Pharynx.
usually causing symptoms of a sore throat.
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Pathophysiology
Most cases of acute pharyngitis are caused by viral
infection.
When group A beta-hemolytic streptococcus
the most common bacterial organism, causes acute
pharyngitis, the condition is known a strep throat .
The body responds by triggering an inflammatory
response in the pharynx.
This results in pain, fever, vasodilation, edema, and
tissue damage, manifested by redness and swelling in
the tonsillar pillars, and soft palate .
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Cont ,,,
Uncomplicated viral infections usually subside promptly
within 3 to 10 days after the onset.
However, pharyngitis caused by more virulent bacteria
such as is a more severe illness.
If left untreated, the complications can be severe and life
threatening. Complications include: sinusitis, otitis
media, peritonsillar abscess, mastoiditis, and cervical
adenitis .
In rare cases the infection may lead to : bacteremia,
pneumonia meningitis, rheumatic fever, or nephritis.
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Clinical Manifestations
The signs and symptoms of acute pharyngitis include
a fiery-red pharyngeal membrane
and tonsils, lymphoid follicles that are swollen
and flecked with white-purple exudate
and enlarged & tender cervical lymph nodes
and Fever & malaise
and sore throat also may be present .
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Assessment and Diagnostic Findings
Rapid strep test (RST) and strep culture require proper
collection technique, because improper collection
reduces the accuracy of the test.
RST must be performed according to the manufacturer's
guidelines. When the test is performed correctly, the
swabs touch both the tonsillar pillars and the posterior
pharyngeal wall; the tongue should not be included. If
the RST result is negative, a second culture should be
performed. Treatment is usually delayed until the
culture results are available .
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Medical Management
Viral pharyngitis is treated with supportive measures
since antibiotics will have no effect on the organism.
Bacterial pharyngitis is treated with a variety of
antimicrobial agents.
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Cont ,,,
PHARMACOLOGIC THERAPY :If a bacterial cause is suggested or demonstrated,
penicillin is usually the treatment of choice.
For patients who are allergic to penicillin or have
organisms that are resistant to erythromycin
cephalosporins and macrolides may be used.
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Cont ,,,
Antibiotics are administered for at least 10 days to eradicate
the infection from the oropharynx.
Severe sore throats can also be relieved by analgesic
medications, as prescribed.
For example, aspirin or acetaminophen can be taken at 3- to
6-hour .
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Cont ,,,
NUTRITIONAL THERAPY :A liquid or soft diet is provided during the acute stage of
the disease, depending on the patient’s appetite and
the degree of discomfort that occurs with swallowing.
Occasionally, the throat is so sore that liquids can not be
taken in adequate amounts by mouth. In severe
situations, fluids are administered intravenously
Otherwise, the patient is encouraged to drink as much
fluid as possible at least 2 to 3 L per day.
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Nursing Management
The nurse instructs the patient to stay in bed during the
febrile stage of illness and to rest frequently once up
and about.
Used tissues should be disposed of properly to prevent
the spread of infection.
Is important to examine the skin once or twice daily for
possible rash, because acute pharyngitis may precede
some other communicable diseases.
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Cont ,,,
Warm saline irrigations are used depending on the severity
of the lesion and the degree of pain.
The benefits of this treatment depend on the degree of heat
that is applied.
The nurse teaches the patient about the recommended
temperature of the solution: high enough to be effective
and as warm as the patient can tolerate, usually (40.5°C to
43.3°C)
Irrigating the throat properly is an effective means of
reducing spasm in the pharyngeal muscles and relieving
soreness of the throat.
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CHRONIC PHARYNGITIS
Chronic pharyngitis is a persistent inflammation of
the pharynx.
It is common in adults who work or live in dusty
surroundings use their voice to excess, suffer from
chronic cough, and habitually use alcohol and
tobacco.
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Cont ,,,
Three types of chronic pharyngitis are recognized :1) Hypertrophic: a general thickening and congestion of the
pharyngeal mucous membrane .
2) Atrophic: a late stage of the type 1 ( the membrane is thin,
whitish, glistening, and at times wrinkled ) .
3) Chronic granular : characterized by numerous swollen,
lymph follicles on the pharyngeal wall .
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Clinical Manifestations
Patients with chronic pharyngitis complain of :
A constant sense of irritation or fullness in the
throat.
Mucus that collects in the throat and can be
expelled by coughing.
and Difficulty swallowing.
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Medical Management
Treatment of chronic pharyngitis is based on
relieving symptoms avoiding exposure to irritants,
and correcting any upper respiratory, pulmonary,
or cardiac condition that might be responsible for
a chronic cough.
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Cont ,,,
Nasal congestion may be relieved by short-term use of
nasal
sprays or medications containing ephedrine sulfate
If there is a history of allergy, one of the antihistamine
decongestant medications, such as Drixoral or
Dimetapp, is taken orally every 4 to 6 hours.
Aspirin or acetaminophen is recommended for its anti
inflammatory and analgesic properties.
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Nursing Management
TEACHING PATIENTS SELF-CARE :-
To prevent the infection from spreading, the nurse instructs the
patient to avoid contact with others until the fever subsides.
Alcohol, tobacco, secondhand smoke, and exposure to cold are
avoided, as are environmental or occupational pollutants if
possible.
The patient may minimize exposure to pollutants by wearing a
disposable facemask. The nurse encourages the patient
to drink plenty of fluids. Gargling with warm saline solutions
may relieve throat discomfort.
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