Influenza: Nursing

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Introduction0:00–0:37

Influenza, commonly known as the flu, is a highly contagious respiratory disease caused by the influenza virus. There are three types of the influenza virus that can infect humans: influenza types A, B, and C.
Influenza types A and B are responsible for the annual regional flu epidemics, or the flu season, which is when cases of influenza rise, and spans from about September to April, with peaks around December to February.
On the other hand, influenza C may lead to mild illness, but not epidemics or pandemics. Now, let’s quickly review the respiratory tract, which can be divided into two regions: the upper respiratory tract and lower respiratory tract.

Physiology0:37–1:34

The upper respiratory tract includes the nose, nasal cavity, the oral cavity, pharynx, epiglottis, larynx, and the upper part of the trachea; while the lower respiratory tract includes the lower part of trachea, and the lungs containing the bronchi, then the bronchioles, onto the alveolar ducts, and finally into the alveoli.
These tiny air-filled sacs are the body’s primary sites of oxygen and carbon dioxide gas exchange. The gases move across the alveolar-capillary membrane, with oxygen moving from the alveolar sacs into the blood, and carbon dioxide moving from the blood into the alveolar sacs to be exhaled.
This allows for a consistent oxygen supply to carry out bodily functions and to maintain the proper blood pH level. Now, the influenza virus invades the respiratory tract and uses it to spread the infection.

Causes & Risk factors1:34–2:47

The flu is typically transmitted from person to person via respiratory droplets or, in some instances, aerosolized particles that are expelled from the respiratory tract of an infected individual.
These droplets can be propelled a few feet into the air when talking, coughing, or sneezing, and can then land in the eyes, nose, or mouths of people nearby, or get inhaled into the lungs.
Less frequently, the virus is transmitted indirectly when an individual touches a contaminated surface and then, prior to washing their hands, they touch their eyes, nose, or mouth.
Individuals are most likely to spread the virus to others 1 day before symptom onset until about 5 to 7 days after becoming sick.
So people are at increased risk for contracting the virus if they have close contact with infected individuals or are in small spaces with large groups of people during flu season, especially if they’re not vaccinated against influenza.
Common places where the influenza virus spreads include schools, work places, nursing homes, or on public transportation.Now, after a person contracts the influenza virus, these infectious little pathogens typically multiply and spread throughout the cells lining the upper respiratory tract.

Pathology2:47–3:52

In response to this, the immune system launches an inflammatory response, which results in visible tracheobronchial redness and swelling, as well as mucous discharge, as these cells start to produce more mucus that can help trap and eventually expel these pathogens.
In certain cases, the disease can become more severe and spread to nearby areas, leading to complications like a sinus or ear infection.
If the virus manages to invade the lower respiratory tract, clients can potentially develop pneumonia, characterized by fluid or pus build up in the lungs.
In addition, the disease may weaken the immune system, making the individual more susceptible to contracting a secondary bacterial infection.
Clients at higher risk of developing complications include children under 5 years of age, and adults over 65, as well as clients who are pregnant or have a chronic heart or lung disease.Typically, the flu manifests as symptoms that present about four days after exposure and last about a week.

Clinical manifestations3:52–4:37

Common symptoms include headaches, fever, chills, fatigue, weakness, and muscle aches. Clients may also experience a runny nose with watery nasal discharge, a sore throat, and a cough.
Upon auscultating the lungs, breath sounds are typically normal. Now, in addition to the other symptoms, influenza B can also lead to gastrointestinal symptoms like nausea, vomiting, and diarrhea.
Most of these symptoms get better in a week, but the cough often persists for up to two weeks, and clients with comorbid conditions or over 65 may have continuing lethargy or weakness for weeks after the flu.Influenza is typically diagnosed based on the client’s history, physical assessment, and knowing there’s an influenza outbreak in the community around the time of symptom onset.

Diagnosis4:37–5:32

In addition, there are three diagnostic tests available to detect the presence of influenza in a client’s respiratory secretions: RT-PCR, rapid molecular assay, and rapid influenza diagnostic tests or RIDTs for short.
RT-PCR and rapid molecular assays can detect viral RNA, and are more accurate, since they have a high sensitivity and specificity and can differentiate between influenza A and B.
On the other hand, RIDTs detect viral antigens, and some RIDTs are able to differentiate between type A and B; these rapid tests have a lower sensitivity and specificity, but they provide faster results within minutes, so they are more commonly used to diagnose influenza.There’s no cure for influenza.

Treatment5:32–6:19

Usually, treatment for influenza involves supportive care to reduce the symptoms; this includes rest and hydration, as well as medications like analgesics, antipyretics, and antihistamines.
In addition, clients may also be treated with antiviral medications such as zanamivir, oseltamivir, and peramivir; these medications can help prevent the release of virus from infected cells, minimizing its spread and reducing the duration of the disease.
Antivirals should be started as soon as possible for clients who are at high risk of developing complications, as well as for those with severe or complicated disease, and for hospitalized clients.
Finally, the most effective way to prevent influenza is through vaccination.Alright, let’s look at the nursing care you’ll provide for a client with influenza.

Management of care6:19–7:10

For most clients with mild symptoms the disease is self-limiting, so the goal of nursing care is to improve ventilation and oxygenation and to provide supportive care.
First, you should regularly assess their respiratory status and breath sounds, and monitor their oxygenation and temperature.
Be sure they receive adequate rest and hydration. ...
You can encourage them to take deep breaths to improve oxygenation and cough to help clear the airways. However, if your client presents with worsening fever, altered mental status, dyspnea, diffuse crackles on chest auscultation, or oxygen saturation dropping below 94%, you need to notify the healthcare provider immediately, as these are indications that the disease is worsening or a complication has developed.
Let’s move onto client and family teaching. Teach your client that they can reduce the risk of spreading the flu to others by covering their mouth and nose with a tissue when sneezing or coughing, then dispose of the tissue right away.

General client & family teaching7:10–9:00

After that, they need to wash their hands for at least 20 seconds with soap and water. Let them know that they should also wash their hands when they blow their nose, rub their eyes, or touch their face.
Finally, advise your client to rest at home and avoid close contact with others as much as possible. Next, teach your client and their household members about prevention.
Some basic ways include avoiding close contact with people who are sick, regularly cleaning surfaces like doorknobs and countertops, and frequent handwashing.
However, the most important prevention is the annual influenza vaccine. Be sure they understand that although vaccination doesn’t guarantee prevention, it will reduce their chances of getting the disease, as well as the severity of their symptoms.
Anyone over 6 months of age can get the vaccination, but it’s especially important if your client is over 50 years old, has a chronic illness, is immune compromised, works as a healthcare provider, is the caregiver of someone with a severe chronic illness, or lives in an institution like a nursing home.
Since the virus strain will change from year to year, so does the annual flu vaccine; so reinforce the importance of getting vaccinated every year.
The best time to get the vaccine is September or October, before the flu season starts.Lastly, go over the contraindications of the annual influenza vaccine with your client, and let them know that they should not get it if they’ve had previous allergic reactions to the vaccine.
Also, if they’ve had hypersensitivity reactions to egg products, they should consult their healthcare provider before vaccination.
Alright, as a quick recap… Influenza, or the flu, is a highly contagious respiratory disease caused by influenza virus types A, B, or C.

Review9:00–10:10

The flu season spans from September to April, and the virus strain causing the flu changes from year to year. The virus is typically spread through aerosolized respiratory particles that enter the body through the respiratory tract, where they multiply and cause inflammation.
Common symptoms include fever, sore throat, cough, runny nose, muscle aches, and headaches. Influenza is typically diagnosed based on history and physical assessment; additional diagnostic tests include RT-PCR, rapid molecular assay, and RIDTs.
Treatment involves supportive care and medications like analgesics, antipyretics, and antihistamines, as well as antiviral medications in certain cases; while prevention involves vaccination.Nursing care includes monitoring the client’s breath sounds, respiratory status, and oxygenation while providing supportive care.
Client and family education is focused on how to limit the spread of the virus and prevent future infections.
Influenza: Nursing: Video, Pathogenesis, Symptoms | Osmosis