Patient education: Tonsillectomy and adenoidectomy in children – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of your child after getting medical care for a health problem.

What is a tonsillectomy and an adenoidectomy? — A tonsillectomy is surgery to remove the tonsils. These are areas of soft tissue in the back of the throat (figure 1). An adenoidectomy is surgery to remove the adenoids. Adenoids are also areas of soft tissue in the throat. They are located higher up than the tonsils.

Doctors can do just a tonsillectomy, just an adenoidectomy, or both. When the tonsils and adenoids are both removed, it is called an "adenotonsillectomy," or "T and A" for short.

How do I care for my child at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for your child. Ask questions if there is anything you do not understand.

You should also:

●Expect your child to have throat pain for 1 to 2 weeks. Ear pain is also common after surgery. If your child only had their adenoids removed, their pain might be less than if they had their tonsils removed.

●Give your child acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin) to help with pain, if needed. The correct dose depends on your child's weight, so ask their doctor or nurse how much to give. Do not give aspirin or medicines that contain aspirin to children, because it can cause a serious problem called Reye syndrome. Aspirin also increases the risk of bleeding after surgery.

●Offer foods that are easy to swallow. Examples include soft bread, gelatin, mashed potatoes, pudding, and applesauce. If your child has an upset stomach, offer bland foods and start slowly to lower the risk of vomiting.

●Offer plenty of liquids. This can be water, juice, broth, or an electrolyte drink that you buy in a store or pharmacy (such as Pedialyte or Gatorade). Your child might not feel like drinking while their throat hurts, but it's important that they get enough liquids.

●Keep your child home from school or day care until their doctor or nurse says that they can go back. Most children should stay home for about a week. They can return once they are eating well and their energy level has returned to normal. They should avoid sports and very active play for at least 2 weeks.

●Make sure that anyone in your home who is sick with a cold or other illness washes their hands often. They should also cover their mouth when they cough. Wearing a mask can help keep germs from spreading.

●Be aware that most children have bad breath after having their tonsils or adenoids removed. This is normal. It usually goes away within 2 weeks.

What follow-up care does my child need? — The doctor or nurse will tell you if you need to make a follow-up appointment. They will probably want to see your child about 2 to 4 weeks after surgery to make sure that they are healing. Make sure that you know when and where to go.

When should I call the doctor? — Call your child's doctor or nurse if your child:

●Has bright red blood coming from their nose or throat – A little blood in saliva or vomit is normal after surgery. But if you see a lot of bright red blood, take your child to the hospital right away.

●Cannot drink liquids

●Has vomiting that does not stop

●Gets a fever

●Has severe throat or ear pain that doesn't get better after a week or 2 or gets worse

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