2-35
2-35. TONSILLECTOMY AND ADENOIDECTOMY
a. Removal of the tonsils and adenoids is indicated in cases of recurrent infections or in cases of swelling that threatens to obstruct the airway.
b. Postoperative nursing management involves maintenance of a patent airway and observation for bleeding and aspiration.
(1) If the operation was done under a local anesthetic, place the patient in a sitting position to maintain airway patency.
(2) If the operation was done under general anesthesia, place the patient in a lateral recumbent position with the head extended. This will allow drainage through the nose and mouth.
(3) Observe vital signs closely and be alert for changes that may indicate bleeding, such as gurgling respirations or excessive swallowing.
(4) Keep the patient as quiet as possible.
(5) Place an ice collar around the neck to constrict blood vessels and reduce pain.
c. An unconscious or bleeding patient should never be left alone. Suction equipment should be available for use. If suctioning is necessary, it should be done carefully and gently to avoid disturbing the operative sites.
d. Encourage the patient to take the diet prescribed by the physician. For the first few days the diet will probably be liquid or semisolid. All foods and fluids should be bland, avoiding citrus, acidic foods, and spices. Diet should be advanced as patient tolerance dictates.
e. Utilize prescribed analgesics, since the throat will be sore for several days postoperatively.
