chapter 25

seasonal influenza

highly contagious acute viral respiratory infection

preventable w/ vaccine

hand washing is critical

antiviral agents effective if started within 24-48

most contagious 24 hours before symptom onset and up to 5 days after

seasonal influenza s/s

headache

muscle aches

fever

chills

fatigue

weakness

anorexia

n/v/d (strain B)

pandemic influenza

varies from mild colds to seasonal flu that leads to pneumonia or death

spread is global

1918 Spanish influenza, COVID

early recognition and quarantine is key

t/x is supportive

COVID-19

coronavirus can cause common cold and includes animal strains that cause severe illness

can sometimes jump species

older adults, immunocompromised, overweight, smokers more at risk

COVID history/ symptoms

vaccination status

exposure to COVID

overall activity and oxygenation

lost of taste and smell

fever/chills

cough

shortness of breath/ resp. symptoms

COVID labs/diagnostics

RT-PCR

home antigen testing

antibody testing

chest imaging

pulse oximetry

COVID implementation

vaccines recommended for high risk individuals 6 months and older and 3 months after recovery

two types of vaccines: mRNA and Bivalent

community prevention measures (hand hygiene, masks, social distancing)

promote gas exchange (oxygen, spirometer, cough/deep breathe)

decrease risk of progression of disease

meds

COID evaluate outcomes

avoid transmission

maintain adequate gas exchange

recover from COVID w/o progression or development of post-COVID condition

return to pre-COVID health status

COVID in 2025

new omnicron variant

symptoms similar to original COVID variant but milder

loss of tase/smell not really a symptom anymore

Pneumonia

develops when pt immune system can’t overcome invading organism

causes excessive fluid in the lungs

if respiratory, formation of thick exudate occurs

lobar: inflammation occurs in section or whole lobe of lung

bronchopneumonia: inflammation is scattered through lung

older adults, unvaccinated, chronically ill, recent resp. illness, smoking more at risk

pneumonia etiology

caused by bacteria, viruses, fungi, and protozoa

streptococcus pneumoniae most common bacterial cause

flu A+B and COVID are most common viral cause

noninfectious causes include smoking, chemicals, gases, aspiration

pneumonia categories

community acquired pneumonia (CAP)

hospital acquired pneumonia (HAP), anything within 48 hrs of admission, higher risk for sepsis

ventilator associated pneumonia (VAP), highest risk of aspiration, HOB at 30 degrees, daily wean assessment, use PVT prophylaxis, oral care, ulcer prevention, suction

pneumonia health promotion

vaccines

avoid crowds

cough, turn, move, deep breathe

clean resp. equipment

avoid pollutants

stop smoking

rest

healthy diet

3 L of water daily

aspiration precautions

pneumonia assessment

risk factors

vaccine status

use of resp. equipment

I PREPARE model

pneumonia s/s

headache

productive cough

sputum (hemoptysis/bloody)

dysrhythmias (hypoxia)

flushing

fever/chills

hypotension

tachycardia

dyspnea/tachypnea, shallow

crackles/wheezing

accessory muscles

pneumonia labs/diagnostics

sputum sample

CBC, BUN, creatinine, lactate (dehydration)

blood cultures

ABG

chest x-ray

pulse oximetry

thoracentesis

pneumonia priorities

decreased gas exchange

potential airway obstruction

potential for sepsis

pneumonia interventions

spirometer

oxygen

cough/deep breathe

pneumonia transition management

home care management

medical equipment (O2, walker, shower chair)

pulmonary tuberculosis

highly communicable disease caused by mycobacterium tuberculosis

transmitted vis aerosolization

not all TB infections develop into active TB

seen more in upper lobes of lung

Latent: asymptomatic period after initial infection (can last years/ decades)

Secondary: reactivation of disease in previously infected person

tuberculosis assessment

past TB exposure

BCG vaccine

travel outside country

tuberculosis s/s

progressive fatigue

lethargy

nausea

anorexia/weight loss

irregular menses

low-grade fever

cough w/ sputum (bloody)

dull aching chest pain

night sweats

crackles/wheezing

tuberculosis diagnostics

1. chest x-ray

2. sputum culture

3. tuberculin blood test (shows how immune system is responding to the bacteria)

4. tuberculin skin test

tuberculosis t/x

meds for 6-12 months (no alcohol)

decrease activity

resp. isolation

promote airway clearance

improve nutrition

reduce drug resistance and infection spread