INFLUENZA

Is a communicable viral disease that affects the upper respiratory system- your nose,
throat & lungs including the upper and lower passages.

Influenza A
 is the group that most commonly causes illness in humans.
 All influenza A viruses are further broken down into H and N subtypes
 There are 16 H subtypes and 9 N subtypes, but only three combinations have actually
caused highly contagious illness in humans.
 The three combinations that cause almost all outbreaks of the flu in humans are H1N1, H2N2
and H3N2.

Influenza B

 There is not much difference between influenza A and B when it comes to how they affect
you.
 Influenza B is not broken down into subtypes like influenza A is, but it is broken down into
individual strains.
 One or two strains of influenza B are included in the seasonal flu vaccine every year to
protect people from the strain(s) that researchers believe are most likely to cause illness
during the upcoming flu seasons
 Influenza B can cause outbreaks of seasonal flu but they occur less frequently than
outbreaks of influenza A.

PATHOPHYSIOLOGY

Common Signs & Symptoms of the flu include:

- Fever over 38 ◦c
- Aching muscles
- Headache
- Dry, persistent cough
- Fatigue and weakness
- Nasal Congestion
Sore throat

Diagnostic Test:
- Physical Exam: Based on the signs and symptoms
Rapid Influenza Diagnostics Test- it looks for substances (antigens) on a swab sample from
the back of the nose or throat. The tests can provide results in about 15 minutes. However,
results vary greatly and are not always accurate.

RISK FACTORS
According to Mayo Clinic People at higher risk of developing flu complications includes:
 Young children under age 5, and specially under 2 years are more likely to have health
complications from the flu virus than most adults.
* Children w/ chronic health condition, like organ disorders, diabetes /asthma, may have
greater risk for developing serious flu- related complications.
For Children and Infant
Call for emergency care or take your child to your doctor immediately if they have:
 trouble breathing
 persistently high fever
 sweats or chills
 a blue or gray skin color
 intense or persistently vomiti
 trouble drinking enough fluids
 a decrease in appetite
 symptoms that initially improve but then get worse
 difficulty responding or interacting

Older Adults (above 65 years)

Has a greater risk for serious complications from the flu.
Flu infection can also worsen long-term health conditions, like heart disease, lung disease,
and asthma.
Call your doctor immediately if you have the flu and are experiencing
 trouble breathing
 persistently high fever
 sweats or chill
 no improvement in health after three or four days.
 symptoms that initially improve but then get worse

 Residents of Nursing Homes and other long- term care facilities.

 Pregnant women & those women up to two weeks postpartum.
 People with weekend immune systems
 People who have chronic illnesses, kidney , liver disease and diabetes.
 People who are very obese, with a body mass index (BMI) of 40 or higher.

Causes:
You can inhale the droplets directly, or you can pick up the germs from an object by
touching inmate objects and soiled with the virus and then transfer them to your eyes, nose or
mouth.

Investigation:
 Throat or nasopharyngeal swabs or aspirates can be cultured for the virus. Results in 3-
14 days.
 Blood serology test. Results in (3 for single convalescent days & 14 for acute &
convalescent days)
 Nasopharyngeal Swab
 Throat Swab
 Rapid bedside test
 Rapid diagnostic test such as Immunofluorescence & ELISA.
 Chest radiograph

MEDICAL MANAGEMENT
 Usually, you'll need nothing more than bed rest and plenty of fluids to treat the flu.
 But in some cases, your doctor may prescribe an antiviral medication, such as oseltamivir
(Tamiflu) or zanamivir (Relenza). If taken soon after you notice symptoms, these drugs may
shorten your illness by a day or so and help prevent serious complications.
 symptomatic medications to relieve symptoms

Treatment:
- Antiviral medication:
* Oseltamivir- oral medication (75 mg orally twice daily)
* Zanamivir – inhalation (10 mg twice daily)
can be used for the tx of influenza A & B
* Amantadine and Rimantadine are effective against influenza A but not influenza B.

Fluzone High- Dose

- this vaccine carries four times the regular dosage.
 Non-productive Cough-Cough suppressant containing dextromethorphan (Robitussin® DM
or Delsym®)
 Productive Cough-Expectorant: Mucinex® tablets or plain guaifenesin syrup (Robitussin®)
 Fever/Headache/Muscle Aches-Acetaminophen (Tylenol®),Non-Steroidal Anti-Inflammatory
Drugs (NSAIDs) such as ibuprofen (Advil®) or naproxen (Aleve®)
 Nasal Stuffiness-Nasal steroid sprays: (Flonase® or Nasacort®);Decongestants:Topical
spray: Oxymetazoline (Afrin® Nasal Spray); limit to 3-4 days maximum;Oral medication:
Pseudoephedrine (Sudafed®)
 Runny and/or Itchy Nose-Antihistamine: Benadryl®, which will likely cause drowsiness, or
Loratadine (Alavert®), which is not as likely to cause drowsiness
 Sore Throat Pain Relief-acetaminophen (Tylenol®) or ibuprofen (Advil®).dry throat sprays
(Chloraseptic®).
 These tx must be given within 36 hrs of onset& administered for 5 days.

Vaccines:
 Flu vaccine – injections and the nasal spray. These antibodies provide protection against
infection with the viruses that are included in the vaccine.
 “Flu Shot”- an inactivated vaccine ( containing killed virus)

 A regular flu shot approved for older than 6 months& older people, including healthy
people, & people with chronic medical conditions.
 A high-dose flu shot approved for people 65 & older.
 An intradermal flu shot approved for people 18 to 64 years of age.
 Continouos of Treatment….
 Nasal-Spray flu vaccine - a vaccine made with live, attenuated flu virus that is given as a
nasal spray (sometimes called LAIV for “ Live Attenuated Influenza Vaccine”).

Who should not get flu vaccine?

People who have severe allergy to chicken eggs.
People who had a severe reaction to a influenza vaccination.
Younger than 6 months of age.
Flu vaccine is needed every year because flu viruses are constantly changing.
Influenza Virus subtypes have shown that the body’s immunity to influenza viruses ( acquired
either through natural infection or vaccination)declines over time.

Patient Teaching
 Bed rest
 Plenty of fluid
 Analgesic to relieve symptoms and maintain good fluids intake.
 Future attack may be avoided by vaccination .
 Avoid unnecessary contact with others during early stages to avoid spreading the virus.
 Wash your hand
 Cover your mouth and nose
 Avoid crowds
 Stay home until fever has been gone for 24 hours.

Nursing Intervention
 Proper assessment and history taking of patient
 Conduct Physical examination
 Monitor respiration noting rate, depth, type of breathing pattern
 Auscultate lungs noting presence of adventitious breath sounds
 Evaluate cough ,presence of secretions
 Proper positioning for maximum lung expansion
 Conduct health teaching

NURSING DIAGNOSIS
Ineffective airway breathing pattern
Diagnostic Division: Respiration.
 Inspiration / expiration that does not provide adequate ventilation.

Related Factors
 Respiratory Muscle Fatigue
 Hyperventilation
 Hypoventilation syndrome (alteration of client’s normal O2 and CO2 ratio.

Defining characteristics:
Subjective:
- Dyspnea (feeling breathless)
- Orthopnea
Objective:
- Use of accessory muscles to breathe
- Nasal Flaring (grunting)
- Bradypnea
- Tachypnea

Desired Outcomes/ Evaluation:

 Establish a normal, effective respiratory pattern as evidenced by absence of cyanosis & other
signs or symptoms of hypoxia, with ABGs within client’s normal or acceptable range.

Actions / Interventions:
 Determine related factors that would cause breathing impairments.

Documentation Focus:
 Assessment, Planning, Evaluation,

REFERENCES:
https://www.mayoclinic.org/diseases-conditions/flu/diagnosis-treatment/drc-20351725
Different Types of Flu: Influenza A, B, C and more www.webmd.com
Influenza Clinical Presentation: History, Physical Examination, Complications
Influenza: Practice Essentials, Background, Pathophysiology
emedicine.medscape.com

COMMON COLDS
Is a viral infectious disease that infects the upper respiratory system. It is also known as
acute viral rhinopharyngitis. It is the most common infectious disease in humans and is mainly
caused by rhinoviruses.
There are more than 200 viruses that cause the common cold, the human body can
never build up resistance to all of them.
colds are so common and often return
The common cold is contagious; it can be spread by air droplets from coughs and
sneezes and by touching infected surfaces.

PATHOPHYSIOLOGY
Common Signs and Symptoms :
sneezing
sore throat/ dry throat
cough
runny nose
blocked nose
mild fever
mild headache

Rarer symptoms of a cold include:

 muscle aches
 shivering
 pink eye
 weakness
 reduction in appetite

DIAGNOSIS
 Thorough history and physical examination are consistent with a viral etiology and no
complications are noted
 Common laboratory tests (eg, WBC, CBC, ESR) have little value. Because of the prolonged
time to obtain positive culture findings, rhinovirus culture has rarely been found useful in
clinical settings.
 Polymerase Chain Reaction(PCR) testing of respiratory specimens may be useful in
evaluating severely immune compromised patients.

RISK FACTORS
Some people are more susceptible to the common cold than others, including:
 children under 6
 older adults
 individuals with weak immune systems
 Smokers
 Anyone who has been around infected individuals is also at risk

CAUSES:
The common cold can be caused by more than 200 different viruses. Around 50 percent of
colds are caused by rhinoviruses, other cold-causing viruses include:
 human parainfluenza virus
 Human metapneumovirus
 coronaviruses adenovirus
 human respiratory syncytial virus
 enteroviruses

Investigation
The common cold is usually diagnosed based on symptoms and diagnostic test are
rarely indicated.

MANAGEMENT
 both antibiotics and antiviral medications are ineffective against most viruses that cause the
common cold.
 A cold normally lasts up to 10 days; however, some symptoms can stay as long as 3 weeks
 treatment is generally focused on symptomatic relief and prevention of person-to-person
spread and complications.

MEDICAL MANAGEMENT
 Rest
 Hydration
 The combined effect of NSAIDs and antihistamines often relieves nasal obstruction.
 Oral decongestants (pseudoephedrine) and topical decongestants (oxymetazoline and
phenylephrine) are commonly used for symptomatic relief.
 In adults, oral zinc reduced duration of illness when high doses (at least 75 mg of elemental
zinc per day) were used and when taken within 24 hours of onset of common cold symptoms.
Zinc has also been associated with faster resolution of nasal congestion, nasal drainage, and
sore throat, as well as improvement of cough (in terms of cough score).
 Children younger than 6 years should receive treatment with analgesics, cough
suppressants, decongestants, or antihistamines only when recommended and
supervised by a physician.
 The FDA recommends against the use of over-the-counter cough and cold medicines in
children younger than 2 years.
PATIENT TEACHING
 Drink plenty of liquids. Choose water, juice and warm soups to prevent dehydration.
 Rest. Get more sleep to help your immune system fight infection.
 Consider pain relievers. Use an over-the-counter pain reliever, such as acetaminophen
(Tylenol, others) or ibuprofen (Advil, Motrin IB, others

Reduce the spread of infection:

 Wash your hands. Thorough and frequent hand-washing is an effective way to prevent many
common infections. Or use alcohol-based hand sanitizers if soap and water aren't readily
available.
 Cover your coughs and sneezes. Cover your mouth and nose when you sneeze or cough.
To avoid contaminating your hands, cough or sneeze into a tissue or into the inner crook of
your elbow.

 Avoid crowds. Flu spreads easily wherever people congregate — in child care centers,
schools, office buildings, auditoriums and public transportation. By avoiding crowds during
peak flu season, you reduce your chances of infection. And if you're sick, stay home for at
least 24 hours after your fever subsides so that you lessen your chance of infecting others.

NURSING INTERVENTIONS
 Disinfect the environment using phenol-alcohol–based compounds
 Positioning the mattress at a 45° angle
 Providing comfortable surrounding temperature and adequate humidity (soothes irritated
nasopharyngeal mucosae and helps eliminate nasal secretions by preventing dryness)
 Using nasal saline drops with bulb-syringe nostril aspiration, in infants with congestion and
obstruction

NURSING DIAGNOSIS
1.Ineffective Airway Clearance: Inability to clear secretions or obstructions from the
respiratory tract to maintain a clear airway.
May be related to
 Tracheobronchial and nasal secretions
 Increased peripheral airway resistance caused by drug therapy
 Pneumonia
Possibly evidenced by
 Rhinorrhea or “runny nose”
 Changes in respiratory rate and depth
 Irritating nonproductive cough
 Decreased breath sounds
 Adventitious breath sounds
 Production of sputum
 Restlessness
 Orthopnea

PLEASE REFER TO: NANDA

Nursing Diagnosis - Complete Guide and List for 2019 – Nurseslabs nurseslabs.com
REFERENCE
https://www.mayoclinic.org/diseases-conditions/common-cold/diagnosis-treatment/drc-
20351611
https://my.clevelandclinic.org/health/diseases/12342-common-cold/management-and-treatmen

THANK YOU
Prepared by:
Shane Sharlette C. Regacho
Nathalie Faith C. Coteng
THANK YOU