Skip Navigation LinksHome > February 2014 - Volume 114 - Issue 2 > CE Test 2.3 Hours: Posttonsillectomy Pain in Children
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000443776.42882.f2
Feature Articles

CE Test 2.3 Hours: Posttonsillectomy Pain in Children

Contrada, Emily

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Continued Education
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* Registration deadline is February 29, 2016.

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To explore the causes of posttonsillectomy pain and provide information about evidence-based best practices for mitigating that pain.

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After reading this article and taking this test, you will be able to

* identify adverse effects associated with tonsillectomy.

* select evidence-based strategies for alleviating posttonsillectomy pain and for improving medication adherence.

1. After tonsillectomy, the risk of immediate or delayed hemorrhage is

a. 1% to 2%.

b. 2% to 4%.

c. 4% to 5%.

d. 5% to 7%.

2. A common adverse effect following tonsillectomy is

a. snoring.

b. sleep apnea.

c. dysphagia.

d. rheumatic fever.

3. What percentage of tonsillectomy wounds become infected?

a. 25%

b. 50%

c. 75%

d. 100%

4. Inflammation in the tonsillar fossae, the uvula, and the pharyngeal wall intensifies during which of the following posttonsillectomy time periods?

a. 12 to 24 hours

b. 1 to 2 days

c. 3 to 5 days

d. 6 to 8 days

5. At which point after tonsillectomy does severe pain dissipate?

a. 10 days

b. 2 weeks

c. 16 days

d. 3 weeks

6. Regardless of the type of tonsillectomy surgery they undergo, the children who seem to have more postsurgical pain are those whose indication for tonsillectomy was

a. recurrent sore throat.

b. tonsillar hypertrophy.

c. obstructive sleep apnea.

d. nasal obstruction.

7. Which of the following perioperative medications has demonstrated effectiveness in reducing swelling, pain, nausea, and vomiting after tonsillectomy?

a. sulcralfate

b. antibiotics

c. dexamethasone

d. hemostatic matrix sealants

8. The cornerstone of posttonsillectomy pain control is

a. iv opioids.

b. oral glucocorticoids.

c. iv sedatives.

d. oral analgesics.

9. In 2013, the U.S. Food and Drug Administration issued a boxed warning contraindicating the use of which of the following medications after tonsillectomy or adenoidectomy in children?

a. codeine

b. morphine

c. oxycodone

d. hydrocodone

10. Used alone, which of the following medications is likely to provide inadequate analgesia for posttonsillectomy pain and can cause hepatic toxicity at higher dosages?

a. diclofenac

b. acetaminophen

c. ibuprofen

d. ketorolac

11. The 2011 American Academy of Otolaryngology—Head and Neck Surgery Clinical Practice Guideline on Tonsillectomy in Children recommends using which of the following medications for pain control after adenotonsillar surgery?

a. diclofenac

b. acetaminophen

c. ibuprofen

d. ketorolac

12. In a prospective study of children undergoing tonsillectomy, what percentage of those who received an age-appropriate patient education booklet including the use of numeric pain intensity scales found it helped with their postoperative pain?

a. 67%

b. 76%

c. 85%

d. 96%

13. Two randomized clinical trials have indicated effectiveness in standardizing discharge teaching for parents of children undergoing adenotonsillectomy, particularly if it instructs parents to

a. provide around-the-clock medication.

b. offer cool fluids frequently.

c. avoid specific diet restrictions.

d. hold younger children on their lap.

14. A study evaluating the use of illustrated informational handouts in helping parents identify postoperative complications found that they had no significant effect in

a. increasing adherence to medication regimens.

b. easing parents’ concerns about adverse effects of surgery.

c. withholding food and fluids because of postoperative pain.

d. reducing the volume of after-hour phone calls to the surgeon.

15. Strategies that might assist parents in managing posttonsillectomy effects include

a. mixing medications in milk or yogurt.

b. avoiding adding sweeteners to medications.

c. administering medications at room temperature.

d. using alcohol-free versions of prescribed analgesics.

16. Which of the following strategies might help lessen pterygoid muscle spasm after tonsillectomy?

a. using a humidifier in the child's room

b. applying a cold pack to the child's neck and jaw

c. having the child chew gum

d. applying a heating pad to the child's neck and jaw

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