Nursing care for a patient with Ludwig’s angina complicated by upper airway obstruction and type 2 diabetes mellitus: Case study.

Abstract

      This study is a case study aiming to study the nursing care of a patient with Ludwig’s angina complicated by upper airway obstruction and type 2 diabetes mellitus. It was conducted on a 66-year-old Thai female who presented with a 2-day history of fever, left submandibular and submental swelling, and dysphagia. Physical examination revealed deep caries in the left lower second and third molars, neck swelling, and mild redness and swelling of the floor of the mouth. The physician diagnosed her with early-stage Ludwig’s angina and initiated treatment with intravenous antibiotics, analgesics, and antipyretics. Subsequently, the infection progressed, leading to increased neck swelling and dyspnea. The physician performed an emergent surgical drainage and a tracheostomy, continuing intravenous antibiotics.

      Results: During hospitalization, the patient's major problems included upper airway obstruction, acute submental and floor-of-mouth infection, high fever, hyperglycemia, acute pain, hypocalcemia and anemia. Key nursing care involved monitoring for signs of severe airway obstruction, administering oxygen, preparing emergency equipment and resuscitation drugs, preparing the patient for urgent surgery, administering prescribed medications (antibiotics, antipyretics, analgesics, and insulin), managing calcium replacement, recommending foods high in iron and calcium, and providing anxiety-reduction nursing interventions. Following treatment, the patient's condition progressively improved; she was safely decannulated from the tracheostomy and discharged home after a 15-day hospital stay.