9 year old male alert and oriented with history of recurrent strep throat over the past two

years,
treated with antibiotics, has asthma treated with bronchodilators and steroids. Patient complains
of sore throat difficulty swallowing, refusing to eat or drink, swollen lymph glands, difficulty
speaking and acute pain when swallowing. Vitals taken: 39.4, 130, 28, 115/74, 87% on RA. Child

Persistent Streptococcal Pharyngitis (Strep Throat) causing

Inflammation of tonsils related to recurrent Streptococcal

recurrent asthmatic attacks

Pharyngitis (Strep Throat) resulting in tonsillitis

Sibilant Ronchi

Dysphagia

Pharyngitis

Dysarthria

Pyrexia

Lymphadenopathy

(Wheezing)

Administer antiinflammatory
medication to
patient to
decrease
swelling and
discomfort
Encourage
client to gargle
salt water pre
and post meals
Increase cool
fluids and food
to soothe throat
from discomfort
Schedule and
promote childs
rest, schedule
uninterrupted
resting periods
Health teach for
client to suck on
lozenges PRN
when
experiencing

Health teach
client to sit in
high fowlers
position when
eating
Provide oral care
pre meals to
increase
salivation
Consult dietician
and client when
planning diet,
incorporate
clients favourite
foods (pureed,
thickened etc)
Health teach
client to limit
amount of food
put in mouth to
one tea-spoon
Consult speech
therapist with

Administer O2
via nasal prongs
2L/min to
increase
oxygenation
Administer
bronchodilator to
patient to
expand patients
airway to
increase comfort
and oxygenation
Reposition
patients bed to
high fowlers to
facilitate patients
lung expansion
Consult
respiratory
therapist to
assess patients
oxygen levels
and to
implement
respiratory

Antibiotic therapy
administered to
relieve swelling
and infection
Apply warm
compress to neck
TID to reduce
Lymph Gland
inflammation
Schedule resting
periods for patient
throughout the
day
Health teach to
client to remain
elevated
throughout the
day to promote
drainage from
gland
Consult family
and patient with
dietician to
enforce new food

Administer
acetaminophen to
client to aid in the
reduction of fever
Health teach client
to wear minimal
layers
Check
temperature QID
to track reduction
of fever
Consult dietician
to increase chilled
fluids (popsicles,
ice chips, chilled
juice)
Implement
frequent sponge
baths to reduce
client temperature
only if chills are
not present

Schedule ultra
sound of neck to
pin point cause
Refer client to a
speech therapist
to help in
rebuilding
speech
Explore options
of client using a
computer to
communicate by
typing
Health teach
safe chewing and
swallowing
techniques and
have patient
demonstrate
them
Health teach
client to avoid
trying to talk
when they feel