Strep Throat Nursing Diagnosis and Care Plan

Last updated on February 20th, 2023 at 09:24 am

Strep throat is an infection affecting the throat and tonsils produced by a bacteria called group A streptococcus, sometimes called Streptococcus pyogenes. This microorganism lives in the nose and throat.

Signs and Symptoms of Strep Throat Infection

The primary indication that strep infection is a sore throat. A viral infection frequently causes a runny nose. A sore throat may also result from viruses and colds. With strep infection, the sore throat develops rapidly and is more likely to accompany any of the following symptoms:

  • Fever (temperature of 101 F or more)
  • Red and enlarged tonsils
  • Discomfort when swallowing
  • Swelling lymph nodes near the front of the neck
  • White spots in the throat
  • Tiny red dots can be seen on the mouth’s roof (called petechiae)
  • Loss of appetite
  • Abdominal pain
  • Headache
  • Body pains
  • Nausea
  • Vomiting
  • Loss of appetite
  • Rash

A painful throat is typically only one of the signs of another infection, like the common cold, and will go away in a few days. The patient should seek to follow-up medical consultation if:

  • Following a couple of days of at-home treatment, symptoms do not improve or start to worsen.
  • There are frequent sore throats, and painkillers do not work to relieve them.
  • A prolonged fever frequently signifies an illness that a doctor should identify and treat immediately.

Causes of Strep Throat Infection

 Group A strep bacteria are highly infectious. Most commonly, individuals distribute the bacteria to others through the following transmission:

  • Respiratory droplets. Most frequently, the nose and throat are home to Group A strep bacteria. When an infected person talks, coughs, or sneezes, it produces respiratory droplets containing the bacteria.  A person may become infected if they:
    • Inhale respiratory droplets that are contaminated with bacteria.
    • Touch objects or surfaces containing those droplets, and then touch their mouth or nose.
    • Sharing food or drink with someone who has group A strep bacteria.

Direct Contact. People can spread group A strep bacteria through infected skin sores. Others may become ill if they have to handle skin sores by group A strep (impetigo) or come into contact with the fluid from the sores.

Infection from strep bacteria can occur in:

  • Tonsils
  • Sinuses
  • Skin
  • Blood
  • Middle ear

Complications of Strep Throat Infection

  • Acute rheumatic fever. A condition that can affect the heart, brain, and joints.
  • Suppurative consequences such as a peritonsillar abscess or mastoiditis
  • Scarlet fever. A red rash can appear as tiny pinpricks that are difficult to spot or as extreme redness on the body that lends it its name.
  • Renal inflammation
  • Poststreptococcal reactive arthritis. A condition that involves inflammation in the joints.
  • PANDAS. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections are another uncommon but incompletely understood complication. Typically, it entails either having OCD condition worsens after a strep infection or developing the tics and routines of OCD following a strep infection.
  • Guttate Psoriasis. A skin condition characterized by the appearance of teardrop scales on the skin’s surface. They could be scratchy and have a red or silver appearance.

Diagnosis of Strep Throat Infection

  • Physical Examination. The doctor will examine the patient and look for symptoms of strep throat or a throat infection if the patient suspects they have strep throat.
  • Rapid antigen test. The doctor may conduct a rapid antigen test on a throat swab sample. This procedure can identify strep bacteria in minutes by examining for substances (antigens) found in the throat. The doctor will use a depressor to press the tongue down gently. After that, a specimen from the back of the throat will be collected using a cotton swab. The results will be available in 20 minutes or less. Prescription of Antibiotics is done if the test results are positive. The doctor might perform a throat culture swab if the result is negative, but strep throat is still suspected.
  • Throat Culture. A throat culture must be performed to determine whether group A strep bacteria develop from the swab. A throat culture can occasionally detect infections that the quick strep test missed. However, it takes longer. Children and teenagers must use culture because untreated strep throat infections can cause rheumatic fever. Following a negative quick strep test, performing a throat culture is usually unnecessary in adults. Adults are not generally at risk of acquiring rheumatic fever after a strep throat infection.
  • Nucleic Acid Test. These identify group A strep DNA in a sample of a throat swab. However, clinicians more frequently employ rapid strep tests and throat swabs due to the more significant costs of these tests.

Treatment for Strep Throat Infection

Medications are available to treat strep throat, ease symptoms, and prevent complications and spread.

  • Antibiotics. If diagnosed with a strep throat infection, the doctors usually prescribe an oral antibiotic. Suppose antibiotics are taken within 48 hours of the start of the sickness. In that case, it can lessen the duration and intensity of symptoms, reducing the possibility of complications and the chance that the infection will transfer to other people. The patient should feel better after receiving treatment in a day or two. Consult a doctor. If the condition doesn’t get better after starting antibiotics for 48 hours, Children who are receiving an antibiotic and are feeling well and do not have a fever can typically go back to school or child care once they are no longer contagious –  usually 24 hours after starting treatment. But make sure to take the entire medication. Stopping too soon can result in recurrences and severe complications, including rheumatic fever or renal damage.
  • Antipyretic and pain relievers. Over-the-counter pain medicines, such as ibuprofen or acetaminophen, can help ease throat pain and reduce temperature. When administering aspirin to kids or teenagers, exercise caution. Although aspirin is safe to use in children above three, it should never be administered to children or teenagers experiencing the symptoms of chickenpox or the flu. Aspirin has been related to Reye’s syndrome in such children, a rare but possibly fatal illness.

Home Remedies for Strep Throat Infection

Most of the time, medications will promptly eliminate the infection-causing bacteria. In addition, try these recommendations to relieve symptoms:

  • Get enough rest and sleep. Enough rest and sleep assist the body in fighting infection. If possible, avoid going to work if suffering from a strep throat infection. In children, keep them at home for at least 24 hours after taking an antibiotic and until there is no longer any trace of fever.
  • Consume plenty of water unless contraindicated. It is easier to swallow and less likely to become dehydrated if the sore throat is maintained moist and lubricated.
  • Consume soft foods. Foods that are simple to swallow include broths, soups, applesauce, cooked cereal, mashed potatoes, soft fruits, yogurt, and soft-boiled eggs. Food can be blended into a puree in a blender to enable them more uncomplicated to swallow. Sherbet, frozen yogurt, and frozen fruit pops are all examples of cold foods that may be calming. Eat less spicy food and less acidic meals or drinks, like orange juice.
  • Use warm, salt water to gargle. Gargling frequently throughout the day can benefit adults and older kids with throat pain. Add 8 ounces (237 milliliters) of warm water to 1/4 teaspoon (1.5 grams) of table salt. Ensure the children understand that they should spit the liquid out after gargling.
  • Make use of a humidifier. Increasing the humidity in the air can assist in reducing discomfort. Pick a cool-mist humidifier and wash it daily, as bacteria and molds can grow in some humidifiers. Nasal saline sprays also assist in maintaining mucous membrane moisture.
  • Avoid irritants. Smoking cigarettes can aggravate a sore throat and make conditions like tonsillitis more common. Paint and cleaning product fumes can irritate the throat and lungs.
  • Promote safety. People can acquire strep throat multiple times. Having strep throat once does not protect a person from getting it again. Although a vaccine cannot prevent strep throat, there are steps people can take to safeguard themselves and others.
  • Maintain good hygiene. Washing hands frequently is the most effective technique to avoid contracting or spreading group A strep. This is particularly necessary after coughing or sneezing and preparing or consuming meals.

Prevention of Strep Throat infection

  • When coughing or sneezing, encourage the patient to use a tissue to cover the mouth and nose.
  • Place used tissues in the trash can.
  • If there is no available tissue, encourage the patient to sneeze or cough into the elbow or upper sleeve rather than with hands.
  • Wash the hands frequently for at least 20 seconds with soap and water.
  • If soap and water aren’t available, use an alcohol-based hand rub.
  • Patients with strep throat infection should refrain from sharing drinking glasses or eating utensils with others.
  • Clean high-touch areas such as doorknobs, counters, and appliance handle regularly.

Nursing Diagnosis Strep Throat Infection

Nursing Care Plan for Strep Throat 1

Ineffective Airway Clearance

Nursing Diagnosis: Ineffective Airway Clearance related to swelling secondary to strep throat as evidenced by ineffective coughing.

Desired Outcomes:

  • The patient will be able to maintain clear airways and will be able to cough up secretions after the interventions and deep breaths.
  • The patient will be able to classify methods to enhance the removal of secretions.
  • The patient will be able to recognize and avoid specific factors that affect effective airway clearance.
  • The patient will be able to conserve a patent airway as demonstrated by a normal respiratory rate and rhythm.
Nursing Interventions for Strep ThroatRationale
1. Check and monitor for the patient’s signs and symptoms of inadequate oxygenation and signs of hypoxia.The patient should be assessed for hypoxia, including confusion, irritability, headaches, pallor, tachycardia, and tachypnea.
2. Advise and encourage the patient to drink fluids in the proper amount.Intake of the proper amount of fluids will help loosen secretions and will also help maintain the moist secretions that will facilitate easy removal.
3. Demonstrate and teach the patient the proper way of doing deep breathing exercises.Deep breathing exercises will help and promote lung expansion and this will also enhance gas exchange and prevent the risk of infection.
4. Evaluate and note the presence of sputum and check for the quality, color, amount, odor, and consistency.The presence of unusual appearance of secretions may be due to infection and other conditions.
5. Advise and instruct the patient to perform oral care every 4 hours.Regular oral care freshens the patient’s mouth after the respiratory secretions have been expectorated.
6. Provide medications as prescribed by the physician such as antibiotics and corticosteroids.Medications such as antibiotics are important to prevent infection caused by bacteria and corticosteroids will help in reducing pharyngeal edema.

Nursing Care Plan for Strep Throat 2

Acute Pain

Nursing Diagnosis: Acute pain related to surgical incision as evidenced by the patient’s statement of pain and nonverbal indications of pain secondary to strep throat such as facial grimace and crying.

Desired Outcomes:

  • The patient will be able to state that the pain is decreased after the interventions.
  • The patient will appear relaxed and comfortable after the interventions.
Nursing Interventions for Strep ThroatRationale
1. Assess the patient’s pain using the accurate pain scale and observe for the patient’s nonverbal indication of pain including its characteristics.Using the appropriate pain scale allows objective measurement of the patient’s subjective pain perception that will help in formulating proper interventions.
2. Advise the patient to refrain from eating hot, spicy, and coarse foods such as chips or crackers.Eating hot, spicy, and coarse foods can aggravate the pain and may cause bleeding.
3. Advise and suggest diversional activities including watching a video, reading a book, listening to music, walking, gardening or dancing.Diversional activities will help in providing distractions from the patient’s pain and discomfort. Suggesting diversional activities can help ease a patient’s pain by directly blocking the pain signals to the patient’s brain.
4. Provide pain medications as prescribed by the physician and monitor for the effectiveness and possible side effects after administration.Strep throat pain is common during the first several days which is usually relieved by pain medications. It is important to monitor for side effects because many medications may cause side effects that may lead to new symptoms and may worsen the existing symptoms.
5. Check the patient’s vital signs and the characteristics of pain every 30 minutes, especially after the administration of pain medications.Monitoring the patient’s vital signs will help the nurse to evaluate the effectiveness of the pain medications. The effectiveness of pain medications for the patient may depend on the peak of the drug administered.

Nursing Care Plan for Strep Throat 3

Deficient Knowledge

Nursing Diagnosis: Deficient knowledge related to lack of information regarding the condition secondary to strep throat as evidenced by the patient’s verbalization and demonstration of lack of understanding about the disease process.

Desired Outcomes:

  • The patient will be able to verbalize knowledge and understanding of the disease and its management.
  • The patient will be able to adequately perform procedures that would help in the condition and the patient would be able to rationalize reasons for actions.
Nursing Interventions for Strep ThroatRationale
1. Identify and evaluate the patient’s understanding of the condition and medical management.Evaluating the patient’s understanding will help the nurse to assess the knowledge of the patient about the condition and its management.
2. Evaluate the patient’s readiness to learn, emotional status, and the patient’s mental capacity to learn.As a nurse, it is important to assess the patient’s readiness to learn and his or her ability and capacity to learn about strep throat.
3. Use different learning modalities after establishing how the patient learns best and offer choices.To promote a better understanding of the condition different learning modalities such as written material, instructional videos, and illustrations may be used when teaching the patient.
4. Establish priorities and don’t overload the patient with information when teaching the patient.Giving too much information may be confusing and overwhelming for the patient. The nurse should consider first the most important for the patient when teaching the patient.
5. Include the patient’s family and significant others when giving information and teaching the patient.Patients may need family members and spouses for support that would help the patient to better understand the condition.
6. Encourage the patient to ask questions if terms and explanations are not clear without any judgment or fear of embarrassment.The patient should be encouraged to ask questions and the nurse should calmly talk to the patient to gain the patient’s cooperation.

Nursing Care Plan for Strep Throat 4

Risk for Deficient Fluid Volume

Nursing Diagnosis: Risk for deficient fluid volume related to inadequate oral intake secondary to strep throat.

Desired Outcomes:

  • The patient will be able to experience adequate fluid volume as evidenced by normal pulse and blood pressure after the interventions.
  • The patient will be able to maintain an intake and output within acceptable limits and parameters.
  • The patient will be able to identify possible causative factors and behaviors that may cause the fluid deficit.
Nursing Interventions for Strep ThroatRationale
1. Assess and monitor the patient’s intake and output every hour and check the patient’s skin turgor and moisture of the patient’s mucous membranes.These will provide information about the changes in fluid balance and may help in detecting dehydration.
2. Monitor and record the patient’s responsiveness and vital signs especially the patient’s blood pressure and pulse rate.The nurse should assess the patient for the presence of restlessness, tachypnea, and tachycardia which are the signs of hypovolemia due to inadequate fluid volume.
3. Check, monitor, and note the color and amount of the patient’s urine.A person’s urine output should not be less than 30 ml/hour and the urine should not be concentrated because concentrated urine indicates a fluid deficit.
4. Check and monitor the patient’s fluid status about the patient’s dietary intake.Fluids come into the patient’s blood through drinking, water in food, and water formed by the oxidation of the patient’s food intake.
5. Check and monitor if the patient is experiencing nausea, vomiting, and fever.The presence of nausea, vomiting, and fever may influence intake and the patient’s fluid needs.
6. Recognize the possible cause of the patient’s fluid disturbance or imbalance.Recognizing and assessing the possible cause of fluid disturbance and imbalance helps in establishing database history that aids in accurate and individualized care for the patient.

Nursing Care Plan for Strep Throat 5


Nursing Diagnosis: Hyperthermia related to bacterial infection and dehydration secondary to strep throat as evidenced by elevated body temperature, flushed skin, tachycardia, and tachypnea.

Desired Outcomes:

  • The patient will maintain a body temperature within normal and acceptable limits.
  • The patient will be able to recognize the factors that may contribute to increased body temperature.
Nursing Interventions for Strep ThroatRationale
1. Check and monitor for signs and symptoms of elevated body temperature and signs of dehydration as a result of hyperthermia.Signs and symptoms of hyperthermia include flushed skin, body weakness, fatigue, headache, and abnormal vital signs should be assessed. Signs of dehydration should also be monitored such as diaphoresis and excessive thirst which indicates a loss of fluids.
2. Evaluate and monitor the patient’s vital signs at least every 4 hours.The patient’s vital signs may appear abnormal due to hyperthermia and may cause rapid heart rate and rapid breathing. The patient’s temperature may be checked accurately using rectal and tympanic thermometers for core temperature assessment.
3. Identify the possible factors that trigger elevated blood pressure and evaluate the client’s history, diagnosis, and procedures.Understanding and identifying the possible cause of elevated temperature will serve as a guide for treatment and nursing intervention.
4. Monitor and evaluate the patient’s fluid intake, urine output, and fluid status.This is important because fluid resuscitation may be required to correct dehydration if dehydration is present.
5. Administer medication such as needed or as prescribed by the physician.Antipyretics help in suppressing elevated body temperature and will provide comfort for the patient and also helps in treating pain, and inflammation. Antipyretics may help the patient decrease the risk of major adverse cardiovascular events.  
6. Provide and maintain a comfortable and cool environment at all times.To provide a comfortable and cool environment, blankets and heavy clothing should be removed, and provide fans for proper ventilation.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon


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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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