IRDS-Avian flu-sars-cov-covid19-rsv-HF

Infant Respiratory Distress Syndrome (IRDS)

Respiratory disorder of premature infants caused primarily by surfactant deficiency and lung immaturity

Hyaline membrane disease

Former name for infant respiratory distress syndrome

Surfactant

Substance that reduces alveolar surface tension and prevents alveolar collapse

Surfactant deficiency

Main cause of IRDS resulting in alveolar collapse and impaired gas exchange

Pulmonary immaturity

Incomplete development of the lungs commonly seen in premature infants

Prematurity

Major risk factor for infant respiratory distress syndrome

Risk factors for IRDS

Prematurity multiple pregnancy maternal diabetes cesarean delivery cold stress asphyxia and previous RDS

Infant of diabetic mother

Newborn at increased risk for IRDS due to delayed surfactant production

Clinical manifestations of IRDS

Rapid respiratory distress in an infant with signs of pulmonary immaturity

Tachypnea

Abnormally rapid breathing commonly seen in IRDS

Grunting

Expiratory sound produced by an infant attempting to maintain alveolar pressure

Nasal flaring

Widening of the nostrils caused by increased work of breathing

Chest retractions

Inward movement of the chest wall during inspiration indicating respiratory distress

Cyanosis

Bluish discoloration caused by inadequate oxygenation

Apnea

Temporary cessation of breathing that may occur in severe respiratory distress

Treatment of IRDS

Respiratory support oxygen therapy and administration of surfactant replacement as indicated

Surfactant replacement therapy

Administration of artificial surfactant to improve lung compliance and reduce alveolar collapse

Nursing priority IRDS

Maintain airway and oxygenation while monitoring respiratory status

Avian influenza

Infectious disease caused by influenza viruses that primarily infect birds and poultry

Bird flu

Common name for avian influenza

H5N1

Highly pathogenic avian influenza strain associated with severe human disease

Hemagglutinin H5

Surface protein of H5N1 influenza virus involved in viral attachment to host cells

Neuraminidase N1

Surface protein of H5N1 influenza virus involved in viral release from infected cells

Avian flu transmission

Spread among birds through saliva nasal secretions droppings and contaminated surfaces

Human risk factors for avian flu

Caring for killing or preparing infected poultry and exposure to contaminated feces eggs or water

Human to human transmission avian flu

Possible transmission through close contact with an infected person

Clinical manifestations avian flu

Fever cough sore throat myalgia nausea vomiting diarrhea and eye infection

Complications avian flu

Pneumonia respiratory failure and acute respiratory distress syndrome

Diagnosis avian flu

PCR testing with sputum or nose and throat specimens

Treatment avian flu

Antiviral medications such as oseltamivir and zanamivir

Oseltamivir

Tamiflu antiviral medication used in the management of avian influenza

Zanamivir

Relenza antiviral medication used in the management of avian influenza

Avian flu prevention

Avoid infected poultry practice proper food handling and cooking and perform hand hygiene

Poultry safety

Measures such as vaccination and culling of infected flocks to control avian influenza

Avian flu health teaching

Wash hands after handling poultry and eggs and cook poultry and eggs thoroughly

SARS-CoV

Coronavirus responsible for severe acute respiratory syndrome

SARS

Severe acute respiratory syndrome caused by SARS-CoV

SARS transmission

Spread primarily through respiratory droplets and close contact with infected individuals

SARS incubation period

Time between exposure to SARS-CoV and development of symptoms

SARS clinical manifestations

Fever cough dyspnea headache fatigue myalgia diarrhea and pneumonia

SARS pneumonia

Pulmonary infection that may develop during the course of SARS

SARS diagnostic tests

Chest x ray blood cultures sputum studies RT-PCR and ABG as indicated

SARS management

Isolation supportive care oxygen therapy and mechanical ventilation when necessary

SARS infection control

Use hand hygiene personal protective equipment environmental cleaning and secretion control

SARS complications

Pneumonia respiratory failure and acute respiratory distress syndrome

Respiratory Syncytial Virus (RSV)

Highly contagious virus that commonly causes respiratory infection especially in infants and young children

RSV infection

Viral respiratory illness that can range from mild upper respiratory infection to severe lower respiratory disease

RSV transmission

Spread through respiratory secretions and contact with contaminated surfaces

RSV risk factors

Prematurity young age chronic lung disease congenital heart disease and immunocompromised status

RSV clinical manifestations

Rhinorrhea cough fever wheezing tachypnea and difficulty breathing

RSV bronchiolitis

Inflammation and obstruction of small airways commonly caused by RSV in infants

RSV pneumonia

Lower respiratory infection caused by RSV that may cause severe respiratory distress

RSV apnea

Temporary cessation of breathing that may occur in young infants with severe RSV infection

RSV diagnosis

Clinical assessment and respiratory viral testing when indicated

RSV management

Supportive care including oxygen hydration and airway secretion management

RSV prevention

Hand hygiene avoidance of sick contacts and infection control measures

Palivizumab

Monoclonal antibody historically used for RSV prevention in high-risk infants

Nursing priority RSV

Maintain airway oxygenation hydration and monitor for respiratory distress

COVID-19

Infectious disease caused by SARS-CoV-2

SARS-CoV-2

Virus that causes coronavirus disease 2019

COVID-19 transmission

Spread through respiratory droplets airborne particles and contaminated surfaces

Common COVID-19 symptoms

Fever dry cough and tiredness

Other COVID-19 symptoms

Aches sore throat diarrhea headache conjunctivitis and loss of taste or smell

Mild COVID-19

COVID-19 without pneumonia or hypoxia with mild systemic symptoms

Moderate COVID-19

COVID-19 with pneumonia without significant respiratory distress and oxygen saturation at least 94 percent

Severe COVID-19

COVID-19 with pneumonia respiratory distress oxygen saturation below 94 percent and need for oxygen supplementation

Critical COVID-19

COVID-19 with respiratory failure ARDS sepsis shock deteriorating consciousness or multiorgan failure

SARS-CoV-2 pathophysiology

Virus enters host cells through the spike protein binding to ACE2 with subsequent inflammation hypercoagulability and possible multiorgan dysfunction

ACE2 receptor

Cellular receptor used by SARS-CoV-2 for entry into host cells

TMPRSS2

Protease involved in SARS-CoV-2 entry into host cells

COVID-19 hyperinflammation

Excessive inflammatory response contributing to tissue injury and organ dysfunction

COVID-19 hypercoagulability

Increased tendency to form blood clots due to impaired coagulation and inflammation

COVID-19 complications

Acute hypoxemic respiratory failure ARDS sepsis shock and multiorgan dysfunction

COVID-19 diagnostic test

SARS-CoV-2 RT-PCR from a respiratory specimen used to confirm infection

COVID-19 laboratory findings

Severe disease may be associated with elevated D-dimer IL-6 CRP procalcitonin troponin LDH and ferritin

COVID-19 chest x ray

May show pneumonia-like infiltrates

COVID-19 supportive care

Includes hydration antipyretics monitoring and appropriate isolation

Remdesivir

Antiviral medication used for selected hospitalized patients with severe COVID-19

Dexamethasone

Corticosteroid used in patients with severe or critical COVID-19 requiring oxygen support

Tocilizumab

Immunomodulatory medication targeting the IL-6 pathway used in selected severe COVID-19 cases

COVID-19 anticoagulation

Anticoagulant therapy may be used to reduce thrombotic complications when clinically indicated

Prone positioning

Positioning strategy that may improve oxygenation in patients with severe hypoxemia or ARDS

High flow nasal cannula

Noninvasive oxygen delivery method used for patients with acute hypoxemic respiratory failure

COVID-19 ARDS

Lung injury associated with severe COVID-19 causing refractory hypoxemia and respiratory failure

COVID-19 nursing priority

Assess airway breathing circulation oxygenation and neurologic status while monitoring for deterioration

Heart failure

Clinical syndrome in which the heart cannot pump enough blood to meet the body's metabolic demands

Left sided heart failure

Heart failure primarily affecting the left ventricle and causing pulmonary congestion

Right sided heart failure

Heart failure primarily affecting the right ventricle and causing systemic venous congestion

Systolic heart failure

Heart failure caused by impaired ventricular contraction and reduced ejection fraction

Diastolic heart failure

Heart failure caused by impaired ventricular relaxation and filling

Heart failure with reduced ejection fraction

HFrEF characterized by impaired systolic function and reduced ejection fraction

Heart failure with preserved ejection fraction

HFpEF characterized by impaired relaxation and filling despite preserved ejection fraction

Low cardiac output

Reduced amount of blood pumped by the heart resulting in inadequate tissue perfusion

Pulmonary congestion

Accumulation of fluid in the lungs due to increased left sided heart pressure

Systemic venous congestion

Accumulation of blood and fluid in systemic circulation due to right sided heart failure