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What is Influenza?
Influenza is a highly infectious, airborne disease. This disease occurs seasonally as an epidemic and manifests as a severe febrile disease with varying symptoms. Other than the virus influenza strain that leads to the seasonal flu being a health issue, other deadly influenza strains have occurred in the past. Influenza infects both human beings and animals. Although certain influenza strains infect certain species, there are new stains that spread from animals to human beings.
Statistics and incidences
Influenza occurs throughout the year in tropical areas.
- WHO estimates that yearly severe illness cases of influenza are 3 to 5 million while the death cases are about 290,000 to 650,000.
- Most deaths associated with influenza disease in developed countries occur among people aged 65 and above.
- In developing countries, the influenza epidemic’s effects are not known fully. However, research estimates by WHO shows that 99% of death of children aged 5 and below with influenza are found in third-world countries.
Either of the three influenza virus types (A, B, and C) can cause Influnza. Influenza can also be caused by the following:
- Direct contact. Infected animals can transmit influenza to humans through contact.
- Poor hygiene in food preparation. There is a higher risk of transmission while slaughtering and preparing for consumption. If the meat is properly cooked, it poses a risk.
- Aerosol transmission. When an infected person sneeze or cough, the virus can transmit from one person to another through the created aerosol. If a person inhales the aerosol, an infection will occur, and the virus will evade the respiratory tract cells and airway if secretory antibodies are not used to neutralize the virus.
- Coming into contact with contaminated objects. If one comes into contact with droppings of infected animals or contaminated water and surfaces, one is at risk of getting infected.
The influenza virus has various symptoms, as discussed below.
- This is one of the respiratory symptoms that could be mild and increase in severity with time. An infected person could also experience dyspnea, pain in the chest, and a dry cough.
- Fever. The body temperature of an influenza patient may vary from one patient to another. While others have very high temperatures, others will experience low temperatures and chills.
- Sore throat. A patient can have a severe sore throat that can last 3 to 5 days. Patients need to seek medical help if they have a sore throat.
- Myalgia. They may range from mild to severe, and they are very common.
- Influenza patients experience fatigue and weakness, resulting in their inability to perform their daily activities, hence the need for more rest.
Nursing Assessment and Diagnostic Findings
Nursing assessment and tests for influenza include the following:
- Rapid diagnostic tests. These are tests used to detect Influenza (A or B) enzymes or antigens. The test involves nasal and throat swabs or nasal washes and can give results within 30 minutes.
- Viral culture. This test takes more time than the rapid diagnostic test and may take 3 to 7 days to produce results.
- Polymerase chain reaction testing. This invitro diagnostic test involves testing the nasopharyngeal secretions in the throat. It’s used as a confirmatory test for the influenza virus.
- Direct Immunofluorescent test. This test is less sensitive than culture approaches.
- Serologic Test. These are used as alternatives to expensive culture methods that consume a lot of time.
- .Avian Influenza test. This rapid test for H5N1 influenza involves taking a nasopharyngeal swab.
- Chest X-ray. Chest radiography is done on high-risk patients and older people with pulmonary symptoms to exclude pneumonia.
The most effective way to manage influenza is by prevention.
- Vaccines. The CDC recommends influenza vaccination to persons aged 6 months and above to prevent seasonal flu.
- .Surveillance. Daily temperature monitoring should be done, and one should isolate by taking home medical leave to avoid spreading.
- Bed rest. Taking bed rest is beneficial to influenza patients as it helps the recovery process that may take up to 3 days though malaise might persist for weeks.
- Older adults and patients with underlying conditions require hospitalization since they can become too weak to care for themselves at home.
- Prehospital care. Patients with respiratory failures should use ventilatory support and obtain intravenous access. A crystalloid bolus should be administered to the patient to support hemodynamic stability.
- Specialists of infectious diseases should be consulted in some seasonal influenza cases. Intensive care specialists should be involved in severe disease management.
Morbidity reduction and preventing complications are pharmacotherapy goals for influenza.
- Antivirals. Antiviral drugs such as baloxavir marboxil, neuraminidase inhibitors, and cap-dependent endonuclease inhibitors are the most commonly used to treat and prevent influenza disease. For example, neuraminidase inhibitors work by reducing the virulence of infection by interacting directly with viral protein.
- Inactivated vaccines. Inactive vaccines are used to prevent influenza disease. The vaccine is administered annually prior to the onset of flu season. The three influenza strains include two influenza A and one influenza B. They are chosen based on their antigenic similarities to the influenza strain expected to spread in the next flu season. Quadrivalent vaccines that have two influenza A and B strains are also accessible.
- Live vaccines. This nasal spray vaccine is appropriate for patients between 2 and 49 years old.
- Uricosuric agents. Uricosuric agents are an adjunctive therapy that could inhibit active oseltamivir metabolite secretion.
Nursing management of an influenza patient includes:
Assessment for people with influenza virus include;
- If a patient has traveled, assess their travel history.
- Physical Exam. This includes examining the work of breathing (WOB) and the use of accessory muscles. Auscultate the lung fields for the rhonchi or reduced breath sounds and the presence of wheezes and crackles.
The following are the major nursing diagnosis for influenza based on assessment data.
- Ineffective airway clearance due to nasal secretion and tracheobronchial.
- Infective breathing pattern due to viral infection inflammation.
- Hyperthermia due to exposure to an infection
- Acute pain due to virus infection
- Deficient knowledge. Relates to a lack of understanding of influenza.
Nursing care planning and goals.
The major goals include:
- Achieving and maintaining a patent airway.
- The patient will have a normal breathing pattern with no breathing sounds.
- Achieving and maintaining normal body temperatures.
- A patient will be relieved from the pain and aches.
- A patient will verbalize and understand proper care and treatment for influenza.
Influenza patients require the following nursing interventions.
- Maintaining a patent airway. Oxygen should be administered as ordered, its saturation should be monitored by pulse oximetry, and the readings should be notified to the physician. Administer bronchodilators and do postural drainage and percussion as ordered. Fluid intake is encouraged, 3-4 liters daily unless there is a contraindication. Encouraging coughing and deep breathing exercises every 2 hours is also recommended.
- Maintain a normal breathing pattern. Chest percussion, postural drainage, and chest physiotherapy should be performed as ordered. The patient should be encouraged to change position every 2 hours. Also, encourage the patient to take at least 2 liters of fluids unless contraindicated.
- Achieving a normal body temperature. Monitor body temperature every 2-4 hours, and with each measurement, antipyretics should be administered as ordered. Tepid sponge baths should be provided, and family members should be instructed to use hypothermia blankets.
- Achieve pain relief. Analgesics should be administered as ordered for the aching muscles; heated pads and warm baths should be provided. Providing throat lozenges and gargling warm water should be encouraged. Nonpharmacologic aids include massage, deep breathing, guided imagery, and relaxation techniques.
- Providing education to patients and folks. Patients receiving vaccines should be educated on the effects and should be advised to report adverse effects to the nearest healthcare immediately. Patients should also be educated on different types of influenza viruses when they occur and ways to avoid being infected.
Nursing goals we achieved if:
- The patients were able to achieve and maintain a patent airway.
- The patient had normal breathing patterns with no breathing sounds.
- A normal body temperature is achieved and maintained by the patient.
- A patient is relieved from the pain and aches.
- A patient’s ability to verbalize and understand proper care and treatment for influenza.
Influenza patients’ documentation includes the following.
- Care Plan
- Teaching plan
- Religious and cultural beliefs and expectations
- Advancement towards desired results.
- Singular findings include interactions, individual behavior specifics, the nature of social exchanges, and factors affecting them.
- Teaching, response to intervention, and actions taken.