Ch. 28 Concepts of Care for Patients with Infectious Respiratory Problems Flashcards
Exam 3
- highly contagious acute viral respiratory infection
- RAPID ONSET of severe headache, muscle ache, fever, chills, fatigue, weakness, anorexia
- preventable (or severity is reduced) with vaccination
- handwashing is critical
- antiviral agents may be effective if started within 24 to 48 hrs of symptoms
seasonal influenza
who are at risk for seasonal influenza
- older adults
- those with heart failure
- chronic lung disorders
- immunocompromised patients
different strains of influenza virus
Influenza A, B, C
when are adults with seasonal influenza contagious
24 hrs before symptoms occur and up to 5 days after symptoms begin
Influenza symptoms
- rapid onset of severe headache, muscle aches, fever, chills, fatigue, and weakness
- can also have sort throat, cough, and watery nasal discharge
influenza B symptoms
- nausea, vomiting, and diarrhea
- most patients feels fatigued for 1 to 2 wks after the acute episode has resolved
annual influenza vaccinations are important for whom to receive?
- > 50 yrs of age
- chronic illness or immune compromise
- reside in institutions
- live with or care for others with health problems that put them at risk for severe complications of influenza
- are health care personnel providing direct care to patients (CDC, 2018a)
are annual influenza vaccinations 100% effective at preventing influenza?
no
what should you instruct your patient with influenza?
- rest for several days
- increase fluid intake unless another problem requires fluid restriction
- saline gargles may ease sore throat pain
- antihistamines may reduce the rhinorrhea
- potential to spread globally
- Avian flu, MERS, SARS
- early recognition and quarantine
- contact and airborne precautions (until specific type of pandemic influenza is identifed with routes of transmission known)
pandemic influenzs
part of adaptive immunity develops as a result of what?
generations of ancestral exposures to common viral families such as rhinoviruses, respiratory syncytial viruses (RSV), and coronaviruses, amoung others
Viral strains change how often and why do adults get several colds a year?
slightly every year so that the antibodies an adult makes against a specific strain one year are not completely effective against exposure to the other strains of that same viral family later that year or another year.
Why does a pandemic respiratory viral infection have the potential to spread globally?
the virus has previously infected only birds or other animals so no human ancestral immunity is present
Most bird and animal viruses cannot be transmitted to humans, but a few notable exceptions have occurred. Why is this? What are some examples?
these viruses mutated and became highly infectious to humans, causing pandemics
* 1918 Spanish influenza and the 2009 H1N1 influenza A
which virus family causes the common cold in humans but also includes bird and animal strains that have caused respiratory influenzas?
coronavirus family
What virus was responsible for jumping from species to another species in 2002 and 2003 causing SARS?
coronavirus
what does SARS stand for
severe acute respiratory syndrome
In 2012 another coronavirus mutation occurred causing a high but demographically confined mortality rate. What was this virus?
MERS-Cov
(Middle East respiratory syndrome)
December 2019 extending into 2020 coronavirus pandemic?
COVID-19
(CO= coronavirus; VI= virus; D= disease; 19= 2019)
Some patients that develop COVID-19 are asymptomatic or experience minimal symptoms, while others experience minor respiratory symptoms similar to a common cold and recover with no apparent long-term effects. What could particularly older adults and individuals with pre-existing chronic conditions develop?
a viral pneumonia that can lead to severe acute respiratory distress syndrome
COVID-19 symptoms
- shortness of breath or difficulty breathing
- new loss of taste or smell
- fatigue
- sore throat
- muscle or body aches
- n/v
- headache
- diarrhea
- fever and chills
- abdominal pain
- cough
What drug class can be used for prevention or to shorten the duration the COVID-19?
antivirals
When must antivirals be started if a patient is suspected of having COVID-19?
within 48 hrs of symptoms onset
Infected patients of COVID-19 in the hospital setting should be placed in what for 7 days?
Droplet/ Airborne Precautions
Unique features in some patients infected with COVID-19
- conjunctivitis
- prothrombotic state (venous thromboembolic disease)
- neurologic findings (encephalopathy with agitated delirium)
- dermatologic findings (especially reddish nodules on distal digits- in young adults)
Indications for Emergency Interventions: COVID-19
- trouble breathing
- persistent pain or pressure in the chest
- new confusion
- inablility to wake or stay awake
- bluish lips or face
- excess fluid in lungs
- can be lobar in nature
pneumonia
Pneumonia from respiratory infection is associated with the formation of what?
thick exudate
All pneumonias have excess fluid in the lungs from what?
an inflammatory process
What are used to dilate the bronchioles and move respiratory secretions for pneumonia patients?
respiratory treatments
If hypoxemia is not improved with oxygen therapy for a patient with pneumonia, what intervention will be done for them?
intubation and mechanical ventilation (may be done)
What is used to treat bacterial pneumonia that may occur with influenza?
antibiotics
Pneumonia may occur as what?
- lobar pneumonia with consolidation in a segment or an entire lobe of the lung
- bronchopneumonia with diffusely scattered patches around the bronci
Bacteria does what in a person whose immune system is compromised?
multiples quickly
what results when an abscess forms and perforates the bronchial wall?
tissue necrosis
Etiology of pneumonia
- organisms such as bacteria, viruses, mycoplasmas, fungi, rickettsiae, protozoa, helminths
- non-infectious causes (inhalation of toxic gases, chemical fumes, and smoke; and aspiration of water, food, fluid- including saliva, and vomitus)
Risk factors for Penumonia: Community- Acquired Pneumonia (CAP)
- is an older adult
- has never received the pneumococcal vaccination or received it more than 5 yrs ago
- did not receive the influenza vaccine in the previous year
- has a chronic health problem or other coexisting condition that reduces immunity
- has recently been exposed to respiratory viral or influenza infection
- used tobacco or alcohol or is exposed to high amounts of secondhand smoke
