B260 Mod 9 - Module 9 - Exam 1 PDF

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Module 9 - Exam 1...

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Fundamentals of Nursing Infection - Module 9 ___

Notes Overview ● Influenza - “flu” ○ Highly contagious, viral respiratory disease ○ Characterized by: ■ Coryza ■ Fever ■ Cough ■ Systemic systems ○ Usually an epidemic (local) or pandemic (global) ○ Identified strains ● Vaccine does not make you sick! Pathophysiology and Etiology ● Short incubation period ● Infects respiratory epithelium ○ Necrosis and shedding of cells ○ Increases risk for secondary bacterial infections ○ Linked to increased risk for pneumonia ■ Young and old ■ Primary viral influenza pneumonia rare ■ Bacterial; pneumonia, exacerbations of COPD ● Reye syndrome

○ Neurological disease ■ Typically following viral infection ■ More likely to affect children ■ Associated with high fever ■ Associated with administration of aspirin products ● When children >12 take it ○ Other potential complications ■ Myositis ■ Myocarditis ■ CNS disorders Etiology ● Transmitted by airborne droplet and direct contact ● Type A influenza viruses ○ Responsible for most infection ● Type B influenza viruses ○ Not responsible for pandemics ● Type C influenza viruses ○ Typically cause mild respiratory infections Risk Factors ● Infants ● Young children ● Over age of 50 ● Residents in long term care facilities (LTC) ● Pregnant women ● Immunocompromised ● Healthcare providers Prevention ● Vaccine recommendation for all individuals - shortages do occur ● Predominant strain varies from year to year ● Vaccine contains egg protein

● Live attenuated vaccine is administered by intranasal spray ● Severe adverse reactions are rare Clinical Manifestations ● One of three syndromes ○ Uncomplicated nasopharyngeal inflammation ○ Viral URI followed by bacterial infection ○ Viral pneumonia - usually harder to treat ● Onset ○ Rapid, profound malaise may develop in minutes ■ Chills, fever ■ Malaise - general feeling of discomfort ■ Muscle aches ■ Headache ■ Cough ● Respiratory symptoms ○ Cough ○ Sore throat ○ Substernal burning - heartburn ○ Coryza - mucus/runny nose ● Acute symptoms subside within 2-3 days ● Fever may last a week ● Fatigue, weakness, cough may last as long as several weeks ● Very young individuals are at high risk for developing complications ○ Viral and bacterial pneumonia ○ Myositis ○ Reye Syndrome ● Client history should include recent travel, interactions with infected animals Collaboration ● Establish diagnosis

○ Local health departments ○ Hospitals ○ Urgent care facilities ○ School nurses & other healthcare providers ● Provide symptomatic relief -> adequate rest and fluid intake ● Prevent complications -> take medications Diagnostic Tests ● History ● Clinical findings ● Knowledge of influenza outbreak in community ● Chest X-ray ● WBC count ● Nasal, throat or nasopharyngeal swabs or washes to obtain specimens Pharmacological Therapy ● Antiviral drugs ○ Zanamivir and oseltamivir ■ Treatment and prophylaxis in people exposed but not vaccinated ○ Antiviral treatment should continue for 5 days ○ Over the counter analgesics provide relief of fever and muscle ache ○ Antitussives for cough -> robitussin Nonpharmacologic Therapy ● Bed rest ● Adequate fluid intake ● Hygiene interventions Nursing Process ● Yearly influenza vaccinations

● Education on disease Assessment ● Health history ○ Known exposure to virus ○ Current symptoms ○ Onset of symptoms ● Physical examination ○ General appearance ○ Vital signs Diagnosis ● Nursing diagnosis may include: ○ Ineffective airway clearance ○ Ineffective breathing pattern ○ Risk for infection ○ Disturbed sleeping patterns ○ Fatigued ○ Deficient community health Planning ● Goals may include that client will ○ Have a temperature within normal limits ○ Maintain normal fluid balance by increasing fluid intake ○ Have oxygen saturation within acceptable limits ○ Maintain a patient airway Implementation ● Maintain airway ○ Assist client to maintain adequate hydration ○ Increase humidity of inspired air with a bedside humidifier ○ Teach effective coughing techniques ● Ensure effective ventilation

○ Shallow respirations increase the risk of atelectasis ■ Pace activities to provide for periods of rest ■ Elevate head of bed ● Promote sleep hygiene ○ Airway congestion, malaise, muscle aches and cough may interfere with rest ○ Assess sleep patterns using subjective and objective information ○ Provide antipyretic and analgesic medications to be taken at or shortly before bedtime ● Prevent infection ○ Prevent individual-to-individual transmission ○ Use standard precautions ○ Frequent hand washing ○ Instruct client, visitors to control secretions ■ Tissues ■ Distance of at least 3 feet from others ■ Use droplet precautions ● Community-based care ● Increase rest during acute, febrile phase ● Maintain liberal fluid intake, even if anorexic ● Appropriate use of OTC meds for symptom relief ● Employ hygiene measures ● Know manifestations of potential complications report to primary care provider Evaluation ● Evaluate client for airway ○ Breathing pattern ○ Oxygenation ● Evaluate for thermoregulation...