Question

Case study questions 1-7

Influenza Case Study JP is a 29-year-old female presenting to the Emergency Department with dyspnea, myalgia, and rhinorrhea. Her symptoms began approximately 1 day ago and are continuous, steadily getting worse. She is having significant nasal discharge but minimal cough. Her 4-year- old son has experienced rhinorrhea as well over the past 3 days, but is not as ill as she is. She has no significant past medical history, and takes no routine medications. She reports receiving the flu vaccine when her child first fell ill. 3 days ago. She was a smoker but quit when she became pregnant 4 years ago. Ten-point review of systems was negative except for fever, lethargy, nasal discharge. shortness of breath, and muscle soreness. Vital signs • T: 101 F .HR: 105 bpm • RR: 22 bpm • BP: 120/76 • Oxygen saturation: 89% on room air, 100% on 2L nasal cannula Physical Exam: Wellnesshed c ontable young HEENT Pupils equally round and reactive to light and accommodation, pou maldichung Whe, les diminished bath Rep Cand AN Regular and the gallope Soft neider, toenal berwende r upo palpation E Neue Naml Radiology: Chest x-ray showed patchy diffuse bilateral infiltrates suggestive of pneumonia Rapid Flu Swab: Positive for influenza type A JP was diagnosed with influenza. The patient was admitted to the hospital for respiratory support and started on the antiviral Tamiflu (oseltamivir). She was not started on antibiotics for bacterial pneumonia, as the patient did not demonstrate typical symptoms of bacterial pneumonia (a notable lack of cough). Also, she had a reasonable alterative explanation for her symptoms and clinical findings. She was discharged after 1.5 days of hospitalization as her ability to oxygenate improved. She completed a 5-day course of oseltamivir at home and returned to usual health within two weeks. 1. What nursing assessment findings support the diagnosis of Influenza? 2. What diagnostic tests (labs, radiology) would you suspect would be ordered to support the diagnosis and why? 3. What type of treatment (medications) would you expect for the patient? 4. What nursing diagnosis should the nurse formulate for this patient? Pick two and explain why, 5. What goals should the nurse develop for the patient? 6. What overall interventions should the nurse provide? 7. What education would you provide to your patient and why?

Answer 1

1) Nursing assessment: ineffective airway clearance in the patient which is evident by running nose and non productive coughs. Ineffective breathing pattern in the patient also account for the influenza infection. Acute pain that is myalgia is seen in the patient. His son also get some infection ad he experiences rhinorrhea for some days. Infiltrates has been seen in xray of the patient.

2) Lab tests: Rapid influenza diagnosis tests to detect typeAnti A or B. Rapid molecular assay as well as immunofluorescence test also support this. Chest radiography can be taken in which opacity in lung where the intensity may be known.

3) antiviral medication like oseltamivir, zanamivir, peramivir. Flu is primarily treated  with rest and fluid intake to fight against infection by body own. Fluid replacement therapy can be given as supportive care. Medication like nasal decongestant, cogh medications NSAID s can be given to improve the symptoms.

4) nursing diagnosis includes ineffective airway clearance, hyperthermia, acute pain and ineffective breathing patterns

Coughing, tachypnea, cyanosis can be evident by the ineffective breathing pattern. This may be related to viral infection.

Body temperature elevated above the normal range is evident by the fever, warm, tachycardia and dehydration in the patient.