The first thing that comes to many people’s minds when they hear the word ‘flu’ is vomiting and diarrhea. Although these are symptoms of influenza, they are often mistaken for a gastrointestinal virus that is known as the ‘stomach flu’. Influenza presents differently, generally lasts longer, and includes fever.
For patients being treated for the influenza viruses it is important to understand that they will be on droplet precautions.
As a nurse, I have only had one flu virus patient that I remember. I recall that the patient presented with the flu but quickly developed pneumonia and was dehydrated from excessive diarrhea and vomiting.
The doctor ordered antibiotics to treat pneumonia but could not administer Anti-viral medication because the patient had already been sick for over 48 hours on arrival. After a few days of antibiotic treatment, electrolyte management, and rehydration the patient was released from the hospital and able to return home.
Influenza, commonly known as the flu, is a highly contagious viral respiratory illness that affects millions of people worldwide each year.
It is caused by influenza viruses and is characterized by a range of symptoms including sudden onset of fever, chills, cough, sore throat, nasal congestion, body aches, fatigue, and headaches. Influenza spreads through respiratory droplets when an infected person coughs, sneezes, or talks, and it can also survive on surfaces for a short period.
While most cases of the flu are mild and resolve on their own, it can lead to severe complications, especially in vulnerable populations such as the elderly, young children, and individuals with weakened immune systems.
Influenza = virus (multiple strains), increasing severity→ Spread through droplet contact
Mr. Moo is a 58-year-old male who comes into the emergency department for suspected influenza. Upon arrival he is coughing and blowing his nose with moderate secretions, has a temporal temp of 102.1 *F, RR 22, O2 sat 89%, body aches with 6/10 pain, and expresses feeling weak. He also states that he has not received his influenza vaccine this year due to fear that it could make him sick. He has no known allergies.
What type of tests will you request to confirm influenza as the nurse? What will be your first intervention for this patient?
*NCLEX tip: knowing appropriate PPE for droplet precaution and patient education are important. After Mr. Moo is treated for the flu how will you educate him about prevention?
Tests to Confirm Influenza:
Given Mr. Moo's clinical presentation and the suspicion of influenza, the nurse should consider the following tests to confirm the diagnosis:
Nasopharyngeal Swab for Influenza: A sample is taken from the patient's nose or throat to detect the presence of influenza virus. This can help determine the specific influenza strain and guide treatment decisions.
Rapid Influenza Diagnostic Test (RIDT): This test provides quick results and can help identify the presence of influenza antigens in respiratory specimens. However, it may have a slightly lower sensitivity compared to other tests.
First Intervention:
The nurse's first intervention for Mr. Moo should focus on addressing his immediate needs and improving his condition. Considering his current symptoms and condition, the following steps should be taken:
Oxygen Therapy: Mr. Moo's oxygen saturation is at 89%, which is below the normal range. Administering supplemental oxygen via nasal cannula or other appropriate methods is essential to improve his oxygen saturation and ensure proper oxygenation of tissues.
It's important to closely monitor Mr. Moo's vital signs, respiratory rate, oxygen saturation, and overall respiratory distress. Additionally, the nurse should provide supportive care by encouraging rest, maintaining hydration, and managing pain and discomfort.
Education
After Mr. Moo is treated for the flu, it's important to educate him about prevention strategies to reduce the risk of future infections. Here's how you can educate him:
Influenza Vaccination:
Emphasize the importance of receiving an annual influenza vaccine. Explain that the vaccine is designed to protect against the most common strains of the virus and can significantly reduce the risk of getting the flu or experiencing severe complications.
Hand Hygiene:
Teach Mr. Moo the significance of proper hand hygiene. Encourage him to wash his hands frequently with soap and water for at least 20 seconds, especially after coughing, sneezing, or touching surfaces in public areas.
Respiratory Etiquette:
Educate him on respiratory etiquette to prevent the spread of respiratory infections. Advise him to cover his mouth and nose with a tissue or the inside of his elbow when coughing or sneezing, and to dispose of tissues properly.
Avoiding Close Contact:
Recommend that he avoids close contact with individuals who are sick, and if he develops symptoms, encourage him to stay home to prevent spreading the virus to others.
Healthy Lifestyle:
Stress the importance of maintaining a healthy lifestyle. A balanced diet, regular exercise, adequate sleep, and managing stress can all contribute to a strong immune system.
Environmental Precautions:
Advise him to clean and disinfect frequently-touched surfaces at home and in his workplace, as the influenza virus can survive on surfaces for a certain period.
Self-Monitoring:
Encourage him to be vigilant about monitoring his health. If he experiences any symptoms similar to the flu, he should seek medical advice promptly to receive appropriate care and prevent potential complications.
Medication Management:
If antiviral medications were prescribed during his treatment, explain their importance and the proper way to take them if future infections occur.
Vulnerable Populations:
If Mr. Moo is in contact with vulnerable populations, such as the elderly or individuals with weakened immune systems, emphasize the need to be particularly cautious to prevent spreading the virus to those who are more susceptible.
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