Pharyngitis

Subject: Medical and Surgical Nursing II (Theory)

Overview

The abrupt inflammation of the pharynx is known as acute pharyngitis. The most prevalent bacterial agent, group A beta-hemolytic streptococcus, is the cause of strep throat, which manifests as acute pharyngitis. The clinical symptoms include throat discomfort, mild malaise, and a low-grade fever. To identify the organism, blood cultures and nasal swabs may also be used. The inflammatory condition of the pharynx that is chronic is called chronic pharyngitis. The objective of nursing care for a patient with viral pharyngitis is symptomatic relief. Instruct the patient to notify the doctor if any symptoms, such as dyspnea, drooling, difficulty swallowing, or difficulty fully opening the mouth, arise.

Acute Pharyngitis

It is the pharynx's abrupt irritation.

Etiology

Viral:

  • Rhinoviruses
  • Influenza
  • Parainfluenza
  • Measles and chicken pox
  • Coxsackie virus
  • Herpes simplex
  • Infectious mononucleosis
  • Cytomegalovirus

Bacterial:

  • Streptococcus
  • Diptheria
  • Gonococcus

Fungal:

  • Candida albacans

Miscellaneous:

  • Toxoplasmosis
  • Chlamydia trachomatics

Pathophysiology

  • Infection
  • The body reacts by inducing inflammation in the pharynx.
  • Results in tissue damage, discomfort, a temperature, vasodilation, and edema.
  • The most prevalent bacterial agent, group A beta-hemolytic streptococcus, is the cause of strep throat, which manifests as acute pharyngitis.

Clinical Features

Milder infection:

  • Throat discomfort, general malaise, and low-grade fever
  • In this instance, the pharynx is obstructed but there is no lymphadenopathy.

Moderate and severe infection:

  • Throat discomfort, difficulty swallowing, headache, fatigue, and a fever
  • Erythema, exudate, enlarged tonsils, and lymphoid follicles are visible on the posterior pharyngeal wall of this case's pharynx.

Very severe infection:

  • Soft palate and uvula edema along with cervical lymph node expansion.
  • A mild viral infection is frequently accompanied by hoarseness and rhinorrhea.

Diagnosis

  • Throat culture
  • To identify the organism, blood cultures and nasal swabs may also be used.

Treatment

General measures:

  • The cornerstones of treatment include bed rest, a lot of liquids, warm saline gargles or pharyngeal irrigations, and analgesics.
  • Before a meal to help with swallowing, lignocaine viscous can relieve local throat discomfort in severe cases.

Specific measures:

  • Penicillin G, 200,000 to 250,000 units orally four times daily for ten days, or benzathine penicillin G 600,000 units intramuscularly once for patients weighing 60 pounds, is used to treat streptococcal pharyngitis.
  • Erythromycin 20 to 40 mg/kg body weight daily in divided oral dosages for 10 days in penicillin-sensitive patients.
  • Diphtheria antitoxin and penicillin or erythromycin administration are used to treat diphtheria pharyngitis.
  • Gonococcal pharyngitis is responsive to standard doses of tetracycline or penicillin.

Chronic Pharyngitis

It is the pharynx's chronic inflammatory condition.

Etiology

  • Persistent infection such as chronic sinusitis, tonsillitis, and rhinitis, as well as dental sepsis
  • Mouth breathing makes the pharynx more vulnerable to infections because it exposes it to air that has not been filtered, humidified, or suited to the body's environment.
  • Chronic irritants include strong drinking, chewing tobacco, excessive smoking, and highly spiced foods.
  • Environmental pollution includes irritating industrial gases, a dusty or smoky environment, or both.
  • Shoddy voice recording

Symptoms

  • Throat discomfort or pain.
  • Feeling of a foreign body in the throat
  • The cost of fatigue.
  • Cough.

Treatment

  • The causes of chronic pharyngitis should be eliminated in every instance.
  • Speech therapy and voice rest are crucial for people with poor voice production.
  • Specially warm saline gargles are calming and ease discomfort in the morning.
  • The pharyngeal mucosa may be painted with Mandl's paint.
  • It is advised to be wary of lymphoid granules.

Nursing Management

  • The objective of nursing care for a patient with viral pharyngitis is symptomatic relief.
  • Nursing care for a patient with strep throat symptoms emphasizes quick diagnosis and medication therapy.
  • Instruct the patient to notify the doctor if any symptoms, such as dyspnea, drooling, difficulty swallowing, or difficulty fully opening the mouth, arise.
  • Tell the patient to stay in bed while they are experiencing a febrile sickness.
  • To stop the spread of infection, used tissues should be disposed of correctly.
  • Because acute pharyngitis can lead to a communicable disease like rubella, check the skin for any potential rashes.
  • Gargles with warm salt water or throat irrigation should be used.
  • A sore throat can also be soothed with an ice collar.
  • When a bacterial infection is present, mouth care should be taken to avoid oral inflammation.
  • Inform the patient and their family about the value of completing the entire course of therapy.
  • Avert exposure to alcohol, smoking, and environmental toxins.
  • Encourage the patient to drink plenty of water and a soft diet

 

 

 
Things to remember
  • The abrupt inflammation of the pharynx is known as acute pharyngitis.
  • The most prevalent bacterial agent, group A beta-hemolytic streptococcus, is the cause of strep throat, which manifests as acute pharyngitis.
  • The clinical symptoms include throat discomfort, mild malaise, and a low-grade fever.
  • To identify the organism, blood cultures and nasal swabs may also be used.
  • The inflammatory condition of the pharynx that is chronic is called chronic pharyngitis.
  • The objective of nursing care for a patient with viral pharyngitis is symptomatic relief.
  • Instruct the patient to notify the doctor if any symptoms, such as dyspnea, drooling, difficulty swallowing, or difficulty fully opening the mouth, arise.
Questions and Answers

Viral:

  • Rhinoviruses
  • Influenza
  • Parainfluenza
  • Measles and chicken pox
  • Coxsackie virus
  • Herpes simplex
  • Infectious mononucleosis
  • Cytomegalovirus

Bacterial:

  • Streptococcus
  • Diptheria
  • Gonococcus

Fungal:

  • Candida albacans

Miscellaneous:

  • Toxoplasmosis
  • Chlamydia trachomatics
  • Persistent infection like chronic rhinitis, sinusitis, tonsillitis dental sepsis
  • Mouth breathing: it exposes pharynx to air which has not been filtered, humidified and not adjusted to body environment making it more susceptible to infections.
  • Chronic irritants like excessive smoking, chewing tobacco and pan, heavy drinking, highly spiced foods.
  • Environmental pollution: smoky or dusty environment or irritants industrial fumes.
  • Faulty voice production.

Treatment:

  1. In every case of chronic pharyngitis, etiology factors should be eradicated.
  2. Voice rest and speech therapy are essential for those with faulty voice production.
  3. Warm saline gargles esp. In the morning are soothing and relieve discomfort.
  4. Mandl’s paint may be applied to the pharyngeal mucosa.
  5. Cautery to lymphoid granules is suggested.

Nursing management:

  1. Nursing management of a patient with vial pharyngitis focuses on symptomatic treatment.
  2. For a patient who have signs of strep throat, nursing care focuses on prompt treatment and administration of antibiotics.
  3. Instruct patient to report to the physician if the signs and symptoms like dyspnea, drooling, inability to swallow, and inability to fully open the mouth appears.
  4. Instruct the patient to stay in bed during febrile stage of illness.
  5. Used tissues should be disposed properly to prevent the spread of infection.
  6. Examine the skin for possible rash, because acute pharyngitis can proceed to some communicable disease like rubella.
  7. Warm saline gargles or throat irrigations should be done.
  8. An ice collar can also relieve a sore throat.
  9. Mouth care should be done to prevent the oral inflammation when a bacterial infection is present.
  10. Instruct the patient and family members about the importance of taking a full course of therapy.
  11. Avoid exposure to environmental pollutants, alcohol, and smoking.

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