Post op care for tonsillectomy

[missninaRN]

My 5 year old niece saw a specialist this week who recommended that she have her tonsils and adenoids removed (outpatient). Her GP has said that hers are the biggest tonsils that he has ever seen and the ENT agreed that they (and the 'noids) are probably the cause of her episodes of sleep apnea.

My sister is about to deliver a baby boy and her hands will be full, so I have volunteered to help care for my precious girl during her recovery from surgery. However, I have not had Peds in school yet.

I don't want medical advice concerning her condition or treatment, but more an idea of what to expect during her recovery: What I should be alert for? Where can I learn about the usual nursing interventions for peds post-op and the normal values for vitals for a 5 year old? (I've already ordered a pediatric BP cuff)

I just want to ensure that I give her excellent care. Thanks for any sources or links you might provide.

[txspadequeenRN, BSN, RN]

Well my 5 year old just had this done and I was told to watch for excessive swallowing (bleeding) and to medicate with pain medications around the clock. I was also told to give very soft foods for a week or so to give the area time to heal. Of course you would watch for a high fever but I think I remember them saying a low grade for a couple of days after was normal. There are white patches that develop a couple days after the procedure that can cause some extra discomfort so be prepared for some delayed grouchinesses. My daughter came home and started playing like nobodies business. She acted like she never had the procedure done. Good luck to you!!!!!!

[canoehead, BSN, RN]

When I worked pediatrics we took the BP on admission and never again. It's not a particularly useful measurement, so save your money. This was during the time when tonsillectomies were kept in the hospital for 24h, and I remember the Tylenol rounds every 4 hours, and constantly pushing fluids. A nurse I worked with had her child's tonsils taken out and she remarked grumpily that her child drank three times what she would have at home before they would let her go home.

Remember to avoid red drinks or you may be fooled into thinking it's blood if she vomits. Vomiting once is normal, (medicate them right away) since they swallow a lot of blood, twice is a real concern, but repeated vomiting needs to be treated aggressively to avoid hurting the suture line.

[missninaRN]

Thanks so much for the advice. I really do appreciate it.

[debthern]

Most of our docs cauterize so it's not such a problem..

Watch for bleeding in the back of the throat, if you see is and she will get her to gargle with ice water while you are calling the doctor. No Sharp foods, chips etc until she's healed. A temp is normal for the first couple of days, make sure she is getting lots of fluids. You can make an icee out of crushed popsicle and sprite, the kids really like them. Just put the popsicle in the micro for about 15 seconds to get it off the stick then smash it and mix in the sprite.