Pediatric Tonsil and Adenoid Post-Operative

Ricky Stone is an 8 year old African American male that arrived at the emergency department driven by his mom Beth Stone. He is 7 days post-operative tonsil and adenoidectomy after multiple reported tonsillitis events over the past year causing him to miss school. Today he vomited at home and filled a bowl of clotted blood. The setting is in a private ED patient room. His throat is very sore so he has not been eating solid food but has been able to eat ice cream and soup. Ricky does not talk much due to difficulty opening his mouth wide, quiet. Throat is sore so he either looks at mom to answer questions, or he gestures, or struggles to answer. Complains of dizziness, near syncopal when asked to stand. Then toward the end of the exam, Ricky vomits a second time, a large amount of bright red blood with clots. Beth – mom is initially relaxed but becomes anxious after Ricky vomits a large amount of blood, worried that he is losing too much blood. Ricky has already vomited a large amount of blood prior to arrival produced by Beth in a bowl covered by a towel.

1. Communicates with an anxious parent regarding the patient’s history to help create an appropriate plan of care
2. Articulates pertinent findings to the care provider and team after examining the post-operative T&A patient
3. Uses assertive communication when collaborating with the physician and members of the team to create a plan of care based on findings of the history and physical exam
4. Initiates and manages appropriate treatment of post-tonsil and adenoidectomy bleeding”

Additional information


Nurse Practitioner, Nursing, Physician Assistant


IU East

Case Setting

Emergency Department


Emergency medicine, ENT

Room Size





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