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Influenza: Concept Map (Nursing and Interprofessional Management and…

- - - - This helps diagnose influenza
      - Determines whether antiviral drugs are a treatment option
- - - - Common complications of influenza include
        
        The onset of flu is typically abrupt, with systemic systemic symptoms:
        
        Fever
        
        Generalized Myalgia
        
        Chills
        
        These signs and symptoms are often accompanied by:
        
        Cough
        
        Sore throats
        
        Headache
        
        Fatigue
        
        Physical examination findings are usually minimal, with normal assessment on chest auscultation
        
        Dyspnea and diffuse crackles are signs of pulmonary complications
        
        Some patients, particularly older adults, experience weakness or lethargy that may persist for weeks.
        
        In uncomplicated cases, symptoms often subside within 7 days
        
        The patient who develops secondary bacterial pneumonia usually experiences gradual improvement of influenza symptoms, then worsening cough and purulent sputum
        
        Treatment with antibiotics is usually effective if started early.
        
        Pneumonia
        
        Primary influenza (primary) (viral) pneumonia
        
        Secondary bacterial pneumonia
        
        Comparison of Common Cold and Influenza:
        
        Common Cold (Viral Rhinitis): Manifestations and Treatment
        
        General aches and pains:
        
        Slight
        
        Stuffy nose:
        
        Common
        
        Headache:
        
        Uncommon
        
        Sneezing:
        
        Common
        
        Fever:
        
        Rare
        
        Sore throat:
        
        Common
        
        Symptoms Onset:
        
        Appear gradually
        
        Chest discomfort, Cough:
        
        Common. Mild to moderate hacking cough
        
        Prevention:
        
        Handwashing. Avoid close contact with anyone who has a cold
        
        Complications:
        
        Sinus congestion. Earache
        
        Treatment:
        
        Temporary relief of symptoms; rest, hydration,decongestants, acetaminophen or ibuprofen for headache, aches, and pains
        
        Influenza: Manifestations and Treatment
        
        Stuffy Nose:
        
        Sometimes.
        
        Sneezing:
        
        Sometimes.
        
        Exhaustion:
        
        Usual. at the beginning of illness.
        
        Sore Throat:
        
        Sometimes.
        
        Fatigue and Weakness:
        
        Usual. Starts early and can last up to 2-3 weeks.
        
        Chest discomfort, cough:
        
        Common.
        
        General aches and pains:
        
        Usual. Often severe.
        
        Complications:
        
        Bronchitis, pneumonia, acute respiratory failure. Can be life-threatening.
        
        Headache:
        
        Common (can be severe).
        
        Prevention:
        
        Handwashing. Annual vaccination. Antiviral drugs. Avoid close contact with anyone who has the flu.
        
        Fever:
        
        Characteristically high 102-104 F (38.9-40 C). Lasts 3-4 days.
        
        Treatment:
        
        Antiviral drugs if given within 24-48 hours of onset. Rest, hydration, acetaminophen or ibuprofen for headache, aches, and pain.
        
        Complications:
        
        Abrupt onset. Within 3 to 6 hours.
- - - - Current vaccinations are highly purified.
      - And reactions are rare.
  - - - Given by injection (Approved for use in people greater than or equal to 6 months of age
        
        Can be used in people at increased risk:
        
        Residents of nursing homes and long-term care facilities
        
        People who are immunocompromised
        
        People of any age with chronic medical conditions
        
        Pregnant women
    - - Given by nasal spray (Approved for healthy people ages 2-49 years
        
        SHOULD NOT be used in
        
        People with known immunodeficiency
        
        Children or adolescents receiving aspirin or other salicylates
        
        Pregnant women
        
        People who have medical conditions that place them at increased risk for complications from influenza (chronic cardiovascular, pulmonary, or neurologic diseases; diabetes mellitus; renal or hepatic dysfunction; hemoglobinopathies).
        
        Children <2 years or adults >50 years
        
        HCPs of high-risk patients because of risk of viral transmission from vaccine (should not care for high-risk patients for 7 days after vaccination).
        
        Most common side effects:
        
        Runny nose and nasal congestion in all ages
        
        Fever in children ages 2-6 years old and sore throat in adults
  - - - Health care workers
      - Residents of long-term care facilities
  - - - Oseltamivir (Tamiflu)
        
        Oseltamivir is available as an oral capsule
      - Peramivir (Rapivab)
        
        Peramivir is given IV
      - Zanamivir (Relenza)
        
        Zanamivir is administered using an inhaler
      - These antiviral drugs are neuraminidase inhibitors that prevent the virus from being released and spreading to other cells
        
        These drugs shorten the duration of influenza symptoms and reduce the risk of complications
        
        Treatment should be initiated as soon as possible in patients who are hospitalized with influenza symptoms
  - - - Nursing Implication:
        
        Zinc lozenges are more apt to cause adverse (bad taste, nausea) than syrup or tablets
        
        Oral zinc should not be taken with foods that will reduce its absorption, such as caffeine and diary products.
        
        Zinc is regarded as relatively safe when taken at recommended doses.
        
        Zinc may interact with drugs, including antibiotics and penicillamine
        
        Intranasal zinc has small linked to a severe side effect (irreversible loss of the sense of smell) and should not be used.
      - Scientific Evidence:
        
        When administered within 24 hours of onset of symptoms, zinc reduces the duration and the severity of cold symptoms
        
        When zinc supplementation is taken in low doses for at least 5 months, the incidence of colds is reduced
        
        Zinc is available in two forms:
        
        Oral zinc (e.g. lozenges, tablets, and syrup).
        
        Intranasal zinc (e.g. swabs and gels)
- - - - Hemagglutinin (H).
      - Neuraminidase (N).
    - - More than 100 types of influenza A are found in
        
        Horses.
        
        Seals.
        
        Pigs.
        
        Swine flu.
        
        Dogs.
        
        Birds.
        
        Avian flu.
    - - Epidemics are more localized outbreaks, usually occurring yearly, caused by variants of already circulating strains
      - When a new viral strain reaches humans, people do not have immunity, and the virus can spread quickly around the globe.
        
        (Example): Type A H1N1 influenza (swine flu) emerged in 2009 and had never been seen in humans before.
        
        A worldwide pandemic resulted.
        
        Pandemics can also occur by the reemergence of a viral strain that has not circulated for many years.
        
        Causing a pandemic.
  - - - Millions of Americans (about 5% to 20% if the U.S. population) contract influenza each year.
      - More than 225,000 people are hospitalize each year for flu-related complications.
      - On average, influenza is responsible for 20,000 deaths annually.
        
        Vaccinations of high-risk groups can prevent many of the deaths.
  - - - Influenza C causes mild illness and does not cause epidemics or pandemics.
      - Outbreaks of influenza B can also cause regional epidemics , but the disease it produces is generally milder than that caused by influenza A.
  - - - This is because most people have partial immunity.
    - - This explains the need for annual vaccination.
  - - - Inhalation of aerosolized particles.
      - To a lesser extent through direct contact with contaminated surfaces.
      - Infected droplets.
    - - (e.g., animal feces).
    - - Continuing for 5 to 7 days after a person first becomes sick.