Unit 1: Influenza

Maintain patent airway

- administer oxygen as ordered - monitor O2 sat - notify physician if O2 less than 90% - high/semi fowlers - administer bronchodilators as ordered - encourage fluids - deep breathing & coughing q2hr

Assessment:

- assess patients travel history - RR, depth & ease of respirations - listen for wheezes, crackles, rhonchi or decreased breath sounds

What are reasons to encourage the client with influenza to stay on bed​ rest?​(Select all that​ apply.) A. To prevent the spread of infection B. To boost the immune system C. To reduce malaise D. To prevent dehydration E. To reduce cough

A, B & C Bed rest reduces​ malaise, boosts the immune​ system, and prevents the spread of infection. Bed rest does not prevent dehydration or reduce cough.

A​ middle-aged client wants to know about the choices of​ over-the-counter drugs for treating flu symptoms. Which nonprescription drugs can the nurse​ suggest?​(Select all that​ apply.) A. Nonsteroidal​ anti-inflammatory drugs B. Acetaminophen C. Aspirin D. Antiemetics E. Antivirals

A, B & C. Nonprescription drugs for treating flu symptoms include​ aspirin, acetaminophen, and nonsteroidal​ anti-inflammatory drugs. Antiemetics are used to treat nausea and vomiting. Antivirals must be prescribed by a health care provider.

The public health nurse is educating social workers working with​ low-income families about the reasons to encourage their clients to get an annual flu shot. What reasons should the nurse include in the educational​ session? (Select all that​ apply.) A. The predominant flu virus strain changes from year to year. B. The new vaccine has specific antigens predicted for that year. C. ​Infants, young​ children, and people aged 50 or older are more likely to get the flu. D. People without health insurance are at higher risk of getting the flu. E. People living in apartment buildings are at higher risk of getting the flu.

A, B, C The predominant flu virus strain changes from year to year. The new vaccine has specific antigens predicted for that year.​ Infants, young​ children, and people aged 50 or older are more likely to get the flu. People living in apartment buildings or who lack health insurance are not at increased risk of getting the flu.

The pediatric nurse is talking to a young​ child's grandmother, who cares for the child during the work week. The grandmother​ can't remember whether she gave aspirin or acetaminophen when the child had a fever. What is the best advice the pediatric nurse can give the grandmother for the​ future? A. Do not give aspirin to children with a fever. B. Write down the medication given as soon as possible. C. Aspirin or acetaminophen work equally well for fevers. D. Do not give acetaminophen to children with a fever.

A.

The residents and staff of a nursing home are in a geographical area with reports of confirmed influenza cases. The nurse administrator has decided to offer antiviral medication to all staff and residents as a preventive measure. When is it safe for them to stop taking the​ drugs? A. After 7 days with no new flu cases B. After 5 consecutive days of medication administration C. After the recipients get immunity to the flu D. After no reported deaths due to flu in 2 days

A.

Which laboratory value supports the diagnosis of influenza? A. Decreased WBC B. Decreased hematocrit C. Increased glucose D. Increased hemoglobin

A.

Emily​ Yi, a​ 27-year-old real estate​ agent, visited a clinic to rule out any bacterial complications after her recovery from influenza. The clinic nurse educated her about​ over-the-counter cough​ suppressants, including the importance of limiting their use. What is the​ nurse's concern? A. The drug could reduce the effectiveness of coughing during the day. B. If taken​ daily, cough suppressants are potentially addictive. C. The drug could make her too sleepy during the day and keep her awake at night. D. The empty calories found in​ pleasant-tasting syrups might cause weight gain.

A. The nurse is concerned about promoting airway​ clearance, which is helped by coughing during the day. The nurse is not worried about addiction​ potential, weight​ gain, or sleep pattern alterations.

The clinic nurse is preparing to give an antiviral drug to an older client with chronic obstructive pulmonary disease​ (COPD) and sickle cell disease. Which ordered medication would cause the nurse to notify the​ prescriber? A. Zanamivir B. Oseltamivir C. Tamiflu D. Xanax

A. The nurse would question the use of zanamivir in a client with COPD because its route of administration is inhalation. Oseltamivir​ (Tamilflu), given​ orally, does not have this caution. Xanax is a medication used to treat anxiety and would not necessitate notifying the health care provider.

An adolescent client with several flu symptoms calls the advice nurse to ask about using cough suppressants. What suggestion from the nurse would promote better airway​ clearance? A. Use cough suppressants during the night B. Use cough suppressants in the afternoon C. Use cough suppressants in the evening D. Use cough suppressants in the morning

A. To promote better airway​ clearance, the client should use cough suppressants only during the​ night, to allow rest. Their use during the day inhibits normal coughing meant to clear the airway.

A client with influenza is prescribed with an antiviral drug. The nurse determines that the client indicates an understanding of the treatment if he or she state the following? A. "I will take the medication exactly as prescribed". B. "I will not be able to infect others while I am on this treatment". C. "I will stop the medication once I feel okay". D. "I will resume my usual activities because these medications have minimal undesirable effects".

A: Antiviral drugs are taken exactly as prescribed. Option B: Antiviral drugs do not prevent the spread of influenza and patients are still contagious for up to two days after the start of the therapy. Option C: The durations for the medications are followed until the last day of the treatment. Option D: Side effects such as dizziness and drowsiness will alert the client to be careful resuming their daily activities.

All of which are examples of antiviral influenza medications except? A. Ethionamide (Trecator) B. Amantadine (Symmetrel) C. Oseltamivir (Tamiflu) D. Zanamivir (Relenza)

A: Ethionamide (Trecator) is an antibiotic used in the treatment of tuberculosis.

Which of the following individuals would the nurse consider to have the highest priority for receiving an influenza vaccination? A. A 60-year-old man with a hiatal hernia. B. A 36-year-old woman with 3 children. C. A 50-year-old woman caring for a spouse with cancer. D. A 60-year-old woman with osteoarthritis.

C: Individuals who are household members or home care providers for high-risk individuals are high-priority targeted groups for immunization against influenza to prevent transmission to those who have a decreased capacity to deal with the disease. The wife who is caring for a husband with cancer has the highest priority of the clients described.

Clinical manifestations

Cough Fever Sore throat Myalgia (muscle pain) Weakness

A newly admitted client is suspected to have avian influenza ("bird flu") due to increasing dyspnea and dehydration. Which of these prescribed actions will the nurse implement first? A. Give first dose of oseltamivir (Tamiflu) B. Instill 5% dextrose in water at 100 mL/hr C. Collect blood and sputum specimens for testing D. Start oxygen using a nonrebreather mask

D: Prioritization. The nurse first action should be to start oxygen therapy because the respiratory manifestations linked to avian influenza are most likely life-threatening. Options A, B, and C: The other actions should also be implemented after addressing the client's respiratory problems.

The caregiver of an older client with flu reports to a geriatric nurse that the client has shallow respiration. What advice can the geriatric nurse give the caretaker to improve the client's ease of breathing?

Elevating the head of the bed will put the client in an upright position and improve the ease of breathing. A​ humidifier, which increases the water content of inhaled​ air, will also improve the ease of breathing.Using a face mask prevents the spread of infection but does not ease breathing. Giving antipyretic or analgesic medications helps with​ comfort, not breathing.

Anti viral drugs for treatment

Neuraminidase inhibitors - oseltamivir - zanamivir

A family of five checks into an urgent care center with symptoms of the flu. Which members of the family are at increased risk of significant​ complications? Newborn baby girl Grandmother with COPD Father with HIV Mother with anemia​ 8-year-old boy

The family members at increased risk of complications are the​ newborn, who fits the category of​ infants; the father with​ HIV, who fits the category of those with a compromised immune​ system; and the grandmother with​ COPD, who fits the category of those with chronic pulmonary disease. Neither the​ 8-year-old boy nor the mother with anemia is at increased risk of complications.

Influenza

airborne