A nurse is caring for a child who is postoperative following a tonsillectomy

Many people are concerned about recovery after tonsillectomy, but if you know what to expect it will be easier. Most of the questions that patients and their families have after surgery are answered below but if you have any other questions please don’t hesitate to call us. Contact information can be found at the end of these are instructions.

Physical Activities
After this surgery, children should rest but may play inside after one or two days and may be outside after three or four days, if they feel up to it. During hot weather special attention should be paid to avoiding dehydration. Strenuous physical activity for 3 to 4 days following surgery is discouraged. Children may return to school whenever comfortable; a week is average, but 10 days is not unusual.

Diet
The single most important factor in helping speed recovery after surgery is staying hydrated. It is very important to make sure your child is drinking fluid consistently after the procedure. You may start with soft foods like ice cream and Jello for 10 days after surgery and then introduce your child’s other favorite foods as they will tolerate them. There is no specific type of food to avoid after surgery but do not try to force your child to eat dry or crunchy foods until they are ready. Often, chewing gum speeds comfortable eating by reducing the spasm after surgery and can be started any time after surgery if they are old enough to have chewing gum.

Pain and Healing
For the first several days (occasionally up to 10 days) following surgery, pain in the throat is to be expected. Children’s Tylenol (acetaminophen) and Children’s Motrin (ibuprofen) can be alternated for pain control. If you received a prescription for narcotic pain medicine it can be used as instructed. Pain is often worse at night and may prompt the need for additional pain medication. A single dose of Tylenol or Motrin in the middle of the night the day of the procedure can help significantly to reduce pain the morning after surgery. Ear pain, especially with swallowing is also a common occurrence; it is not an ear infection but due to referred pain from the surgery. White patches in the back of the throat and bad breath are common after the surgery. They are part of the healing process and do not indicate an infection.

Ice Collar
An ice collar can also be helpful for post-operative sore throat. Make this by placing ice cubes and water in a large Zip-Loc bag and wrapping it in a towel. Gently lay the ice pack on the front of the neck.

Fever
A low-grade fever (less than 101 degrees) following surgery may occur and should be treated with Tylenol (acetaminophen). Follow the directions on the bottle. While children have a fever, they should play quietly or remain in bed. If the fever persists (more than two days) or if a higher fever develops, call your surgeon. Fever may indicate that you have not taken in sufficient fluids or may have an infection.

Bleeding
Post-operative bleeding is unusual, but it can occur up to two weeks after surgery. Watch for spitting, coughing, or vomiting of blood. If you suspect bleeding following surgery, call immediately.

If bleeding is minor and your child is old enough it can sometimes be controlled at home. Take a large glass and fill it to the brim with ice and then water. Have your child gargle and spit out water until they have gone through all the water in the glass and then repeat this a second time. If by the end of the second glassful there is no trace of blood in the water they are spitting out, it is alright to watch them closely rather than bring them in for evaluation. If they continue to have bleeding please bring them to the emergency room so that they can be evaluated.

Follow up
You should have an appointment scheduled for a short postoperative checkup about one month after surgery. If you are unsure when this appointment is scheduled, please contact us.

A nurse is caring for a child who is postoperative following a tonsillectomy

Pediatrics CMS - Review Questions

1. A nurse is assessing a school-age child who has heart failure and is taking furosemide. Which of

the following findings should the nurse identify as an indication that the medication is effective?

a. An increase in venous pressure

b. a decrease in peripheral edema

c. a decrease in cardiac output

d. an increase in potassium levels

2. A nurse is assessing an infant who has acute otitis media. Which of the following findings should

the nurse expect (select all that apply).

a. Increased appetite

b. enlarged subclavian lymph node

c. Crying

d. Restlessness

e. Fever

3. a nurse is providing teaching to the parents of an infant who is to undergo pilocarpine

iontophoresis Testing for Cystic Fibrosis. Which of the following statements should the nurse

include in the teaching?

a. We will measure the amount of protein in your baby's urine over 24 hour period

b. The test will measure the amount of water in your baby’s sweat

c. a nurse will insert an IV prior to the test

d. your baby will need to fast for 8 hours prior to the test

4. A nurse in an urgent care clinic is prioritizing care for children. Which of the following children

should the nurse assess first?

a. A toddler who has nephrotic syndrome and facial edema

b. a preschool-age child who has a muffled voice and no spontaneous cough

c. a preschool-age child who has diabetes mellitus and a blood glucose of 200 mg/dL

d. an adolescent who has Crohn's disease and recent weight loss of 5kg mg (11 lb)

5. A nurse is providing teaching to the parents of a toddler who is to undergo a sweat chloride test.

Which of the following statements should the nurse include?

a. The purpose of the test is to determine if your child has Crohn's disease

b. the technician will use a device to produce an electrical current during the test

c. during the test, your child will be in a room that is cold

d. your child sweat will be collected over 24 hours

6. A nurse in the emergency department is caring for an adolescent who is requesting testing for

STI. Which of the following action is appropriate for the nurse to take?

a. Request verbal consent from the social worker

b. contact the client's parents to obtain phone consent

c. postpone the testing until the client's parents are present

d. obtain written consent from the client

7. A nurse in the emergency department is assessing the toddler who has hyperpyrexia severe

dyspnea and drooling which of the following actions should the nurse take first?

Which fluids would the nurse recommend the parents offer their child after a tonsillectomy?

Offer your child small amounts of fluids (half a cup) every hour during waking hours for the first few days after his/her tonsillectomy. Try cool fluids first such as water, cordial, ice blocks, and non-acidic fruit juices (ie apple juice) and soft drinks (let them stand to de-fizz first).

Which is the most appropriate nursing intervention for a child after tonsillectomy quizlet?

After tonsillectomy, suction equipment should be available, but suctioning is not performed unless there is an airway obstruction because of the risk of trauma to the surgical site. Monitoring for bleeding is an important nursing intervention after any type of surgery.