Influenza, Diagnosis of Influenza, Treatment for Influenza, Prevention of Influenza, and 7 Nursing Care Plan Examples for Influenza.

Influenza, Diagnosis of Influenza, Treatment for Influenza, Prevention of Influenza, and 7 Nursing Care Plan Examples for Influenza.

This study guide is about influenza, diagnosis of influenza, treatment for influenza, prevention of influenza, and 7 nursing care plan examples for influenza. It can be used to create educational nursing care plans for influenza.

Influenza

What is influenza?

Influenza, Diagnosis of Influenza, Treatment for Influenza, Prevention of Influenza, and 7 Nursing Care Plan Examples for Influenza.
Influenza

Influenza, also known as flu, is a common viral infection caused by influenza viruses and affects the respiratory system. The patient groups that are at high risk for influenza involve young children under the age of 5 and old people over the age of 65. Immuno-compromised patients and nursing home residents are also at high risk of contracting this viral infection. Prevention of influenza involves annual vaccination, although it is not fully guaranteed to prevent flu. In most cases, treatment can be done at home with fluids and plenty of rest. Worsening of flu symptoms requires urgent medical attention.

What are the signs and symptoms of influenza?

  • Usually dry cough
  • Nasal congestion – stuffy nose
  • Sneezing
  • Sore throat
  • The onset of high fever
  • Dyspnea – the difficulty of breathing
  • Headache
  • Tiredness and fatigue
  • Chills
  • Myalgia – muscle aches
  • In children, gastrointestinal symptoms such as nausea, vomiting, and diarrhea may be evident

What are the causes and risk factors of influenza?

Influenza viruses are transmitted via the air droplet method through coughing, sneezing, or even talking. The droplets can be inhaled directly or can be transferred indirectly through touching objects contaminated with the virus. These influenza viruses are changing constantly and research reveals that new strains come out annually, thus the need for annual vaccination.

The following risk factors can make an individual experience a serious case of influenza:

  • Age – common on those children ages 6 months- to 5 years old
  • Certain residential or work conditions – those who reside and have a job in hospitals or care facilities, or those who live in military barracks
  • A weakened immune system such as people on treatments that block or weaken the immune system, such as chemotherapy and steroids; people who that are immunocompromised, such as HIV or AIDS
  • Chronic illnesses that need a regular follow up such as diabetes and other metabolic disorders
  • Race/Ethnicity –Native Americans are at high risk for influenza.  Influenza interventions might be difficult to implement in those minority areas, because of some factors like broad disparities in health and social status, as well as barriers in culture, education, and language
  • Long-term aspirin therapy -especially on children and adolescents
  • Pregnancy – particularly in the 2nd and 3rd trimesters
  • Obesity – having a body mass index (BMI) of above 40

Diagnosis of Influenza

How do you diagnose influenza?

Diagnosis of Influenza

  • Physical exam – people with flu usually manifest respiratory symptoms such as fever, colds, sore throat, nasal congestion, headaches, myalgia or body aches, chills, and fatigue
  • Rapid Influenza Diagnostic Test (RIDTs) -one of the most common flu tests; detects the antigen part of a virus by stimulating an immune response
  • Chest X-ray – on severe cases

What will happen if influenza is left untreated?

Normally, a patient with influenza is expected to have recovered after a few days or less than two weeks. However, some people may develop complications such as:

  1. Dehydration
  2. Pneumonia or bronchitis
  3. Sinus and ear infection
  4. Myocarditis/ heart inflammation
  5. Encephalitis
  6. Myositis

Treatment for Influenza

What treatment options are available for a patient suffering from influenza?

Treatment for Influenza

  1. At-home care. Mild cases of influenza can be resolved by having plenty of rest and proper hydration. It is important for the patient to eat right and stay at home to lessen exposure and possible transmission of the virus to other people.
  2. Antipyretics and pain relievers. The patient can be prescribed antipyretics to lower fever as well as to relieve muscle aches.
  3. Antivirals. Severe influenza infections can be treated by antiviral medications that can be oral or intravenous in form. They aim to reduce the number of sick days of the patient and to prevent the development of serious complications.

Prevention of Influenza

How can influenza be prevented?

Influenza can be prevented from spreading and infecting others by:

  • Proper handwashing
  • Cleaning of objects and surfaces
  • Covering the mouth when coughing
  • Avoiding crowded places

7 Nursing Care Plan Examples for Influenza

What are some of the available nursing care plans for influenza?

Nursing Care Plan 1

Ineffective Airway Clearance related to nasal congestion secondary to influenza as evidenced by shortness of breath, wheeze, SpO2 level of 92%, cough,

Desired Outcome: The patient will be able to maintain airway patency and to improve airway clearance as evidenced by being able to expectorate phlegm effectively, respiratory rates between 12 to 20 breaths per minute, oxygen saturation within the target range (usually above 96%), and verbalize ease of breathing.

Interventions Rationales
Assess the patient’s vital signs and characteristics of respirations at least every 4 hours. Assess breath sounds via auscultation. To assist in creating an accurate diagnosis and monitor the effectiveness of medical treatment. Breath sounds are important signs of complications of severe influenza such as pneumonia and bronchitis.
Suction secretions if needed. To help clear any phlegm that the patient is unable to expectorate.
Administer supplemental oxygen, as prescribed. Discontinue if SpO2 level is within the target range, or as ordered by the physician. To increase the oxygen level and achieve a SpO2 value within the target.
Administer the prescribed medications (e.g. antivirals and antipyretics). To help treat influenza and resolve temperature.
Elevate the head of the bed and assist the patient to assume semi-Fowler’s position. Head elevation and proper positioning help improve the expansion of the lungs, enabling the patient to breathe more effectively.

Nursing Care Plan 2

Nursing Diagnosis: Ineffective Breathing Pattern related to nasal congestion secondary to influenza as evidenced by shortness of breath, SpO2 level of 92%, and dry cough

Desired Outcome: The patient will achieve an effective breathing pattern as evidenced by respiratory rates between 12 to 20 breaths per minute, oxygen saturation within the target range, and verbalizing ease of breathing.

Interventions Rationales
Assess the patient’s vital signs and characteristics of respirations at least every 4 hours. To assist in creating an accurate diagnosis and monitor the effectiveness of medical treatment.
Administer supplemental oxygen, as prescribed. Discontinue if SpO2 level is within the target range, or as ordered by the physician. To increase the oxygen level and achieve a SpO2 value within the target range.
Administer the prescribed medications (e.g. antivirals and antipyretics). To help treat influenza and resolve temperature.
Elevate the head of the bed. Assist the patient to assume semi-Fowler’s position. Encourage plenty of rest and adequate hydration. Head elevation and semi-Fowler’s position help improve the expansion of the lungs, enabling the patient to breathe more effectively.
Perform chest physiotherapy such as percussion and vibration, if not contraindicated. Nebulization using sodium chloride (NaCl) may also be done, as ordered by the physician. Steam inhalation may also be performed. To facilitate the clearance of any thick airway secretions.

Nursing Care Plan 3

Nursing Diagnosis: Activity intolerance related to the difficulty of breathing secondary to influenza, as evidenced by fatigue, overwhelming lack of energy, verbalization of tiredness, generalized weakness, headache, and shortness of breath upon exertion

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate an increase in activity levels.

Interventions Rationales
Assess the patient’s activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try. To create a baseline of activity levels and mental status related to fatigue and activity intolerance.
Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media for long periods. Alternate periods of physical activity with 60-90 minutes of undisturbed rest. To gradually increase the patient’s tolerance to physical activity. To allow the patient to pace activity versus rest.
Teach deep breathing exercises and relaxation techniques.  Provide adequate ventilation in the room. To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.

Nursing Care Plan 4

 Nursing Diagnosis: Risk for Infection (Cross-contamination)

Desired Outcome: The patient will be able to avoid the cross-contamination of the viral infection.

Interventions Rationales
Assess vital signs and observe for any signs of infection as well as for any signs of respiratory distress. To establish the patient’s baseline and monitor for any changes in vital signs and flu symptoms.
Place the patient in isolation and provide adequate ventilation in the room. To reduce the risk of infecting other patients, staff, and visitors in the hospital ward or care facility. To allow enough oxygenation in the room.
Obtain a sputum sample for culture if the patient develops any phlegm. To confirm the presence of any complication of influenza (such as pneumonia or bronchitis) and its causative agent.
Teach the patient how to perform proper hand hygiene, covering the mouth when coughing, and oral care. To maintain patient safety. To prevent spreading airborne pathogens and reduce the risk of cross-contamination.

Nursing Care Plan 5

Nursing Diagnosis: Hyperthermia related to the infective process of influenza as evidenced by the temperature of 38.5 degrees Celsius, rapid and shallow breathing, flushed skin, profuse sweating, and weak pulse

Desired Outcome: Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.

Interventions Rationales
Assess the patient’s vital signs at least every 4 hours. To assist in creating an accurate diagnosis and monitor the effectiveness of medical treatment, particularly the antivirals and antipyretics administered.
Remove excessive clothing, blankets, and linens. Adjust the room temperature. To regulate the temperature of the environment and make it more comfortable for the patient.
Administer the prescribed antiviral and anti-pyretic medications. Use the antiviral to treat the viral infection, which is the underlying cause of the patient’s hyperthermia. Use the antipyretic medication to stimulate the hypothalamus and normalize the body temperature.
Offer a tepid sponge bath. To facilitate the body in cooling down and to provide comfort.
Elevate the head of the bed. Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively.

Nursing Care Plan 6

Nursing Diagnosis

  • Acute Pain

It may be related to

  • Influenza virus
  • Pneumonia
  • Coughing

Possibly evidenced by

  • Verbalization of pain
  • Fever
  • Cough with or without production
  • Body aches
  • Malaise

Desired Outcomes

  • The patient will achieve relief from aches and pain
  • The patient will report pain is controlled or eliminated
Nursing Interventions Rationale
Assess patient for complaints of headaches, sore throat, general malaise or body weakness, muscle aches, and pain. Caused by inflammation or elevated temperature.
Assess changes in vital signs. Vital signs are usually increased as a result of autonomic response to pain.
Administer analgesics as ordered. Pharmacologic therapy to control pain and aches by inhibiting brain prostaglandin synthesis.
Provide a restful, quiet environment. Reduces stimuli that may increase pain.
Provide warm baths or heating pads to aching muscles. Warmth causes vasodilation and decreases discomfort.
Provide cool compress to head. Promotes comfort and treats headaches.
Provide backrubs as needed. Promotes relaxation and relieves aches.
Encourage gargling with warm water; provide throat lozenges as necessary. Reduces throat discomfort.
Instruct patient or SO in deep breathing, relaxation techniques, guided imagery, massage, and other nonpharmacologic aids. Helps the patient to focus less on pain, and may improve the efficacy of analgesics by decreasing muscle tension.
Instruct patient or SO regarding the use of acetaminophen and to avoid the use of aspirin. Acetaminophen may relieve pain and headache but should be used cautiously in patients with liver dysfunction because of acetaminophen metabolism in the liver. Aspirin can potentially cause hemorrhage and ulceration, therefore, must be avoided.

Nursing Diagnosis

  • Deficient Knowledge

It may be related to

  • Lack of knowledge about the disease process (Influenza)
  • Inability to avoid complications
  • Recurrence of disease

Possibly evidenced by

  • Verbalization of misconceptions, questions about the disease
  • Request for information
  • Presence of avoidable complications

Desired Outcomes

  • The patient will be able to understand and verbalize appropriate treatment and care for influenza.
  • Patient and/or SO will be able to accurately verbalize understanding of the influenza disease and methods to use to avoid contracting the illness.
  • Patient and/or SO will be able to notify the physician immediately during flu season if the patient begins to have symptoms of influenza in order to be treated with antivirals.
  • The patient will suffer no complications, such as pneumonia, requiring hospitalization.
  • The patient will be compliant with obtaining annual influenza vaccination.
Nursing Interventions Rationale
Assess the patient’s understanding of the disease process. Patients may have misconceptions about the disease that should be corrected. Identifying baseline knowledge helps to facilitate and establish a plan of care for patient and family education.
Ensure that the patient is willing and able to listen to information about the disease. The patient may be in too much pain or too ill to understand and comprehend information. If the patient is unwilling to listen to information, accept the decision, which will help to facilitate acceptance of right as a patient to choose the level of self-participation in care.
Use limited amounts of time for teaching, with the provision of a quiet environment. Helps the elderly patient to remember the information being discussed without distracting stimuli. Limiting sessions of instruction helps to avoid overstimulation and overload.
Educate about influenza immunizations. For high-risk patients and healthcare personnel, suggest annual inoculations at the start of the flu season. Note that some vaccines are made from a chicken embryo and should not be given to people who are hypersensitive to eggs. The vaccine administered is based on the previous year’s virus and is usually about 75% effective.
Inform people receiving the vaccine of the possible adverse effects and report them immediately. Adverse effects include discomfort at the vaccination site, fever, malaise, and rarely, Guillain-Barre syndrome. Recommend the inactivated variant of the vaccine to women who are pregnant and who will be in the second or third trimester during influenza season.
Teach the proper disposal of tissues and proper hand-washing techniques. To prevent the virus from spreading.
Use appropriate teaching aids for the patient’s abilities. Teaching aids such as written in large font for the impaired patient, and so forth helps to provide information in a manner that will be more easily understood by the patient and remembered. Normal aging changes may cause memory loss, sensory deficits, and the need for slower, more repetitive teaching.
Instruct patient and/or SO about influenza types, when typical outbreaks occur, and methods to avoid infection. Influenza occurs every year, normally from November through April, and the virus is spread via direct contact or aerosol droplets. Elder people usually have other disease processes, are especially prone to infection, and should avoid others who have upper respiratory symptoms when possible.
Instruct patients and/or SO that those who are at risk for influenza should always be immunized with the flu vaccine. Vaccination should be given around October prior to the start of the outbreak of influenza season but can be given throughout this time until late winter. Prevention of influenza is considered optimal in order to prevent complications, such as pneumonia.
Instruct patient and/or SO about newer antiviral drugs, their effects, when to seek immediate medical attention, and side effects of medications. Caution should be used if patients have other respiratory diseases or renal insufficiency. Tamiflu (oseltamivir phosphate) and Relenza (zanamivir) are effective for influenza types A and B. Rimantadine and amantadine are effective for influenza A. These drugs are given within 48 hours of the onset of symptoms for maximum efficacy. 

Patients should be also be advised these drugs are not replacements for their annual vaccination.

Other nursing diagnoses:

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.

 

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