Influenza (Flu) Disease What you need to know

Influenza is also known as (flu): is an acute, highly contagious viral respiratory infection that is caused by one of three types (A, B, or C) of myxovirus influenzae. Influenza occurs all over the world and is more common during winter months. The incubation period is 24 to 48 hours. Symptoms appear approximately 72 hours after contact with the virus, and the infected person remains contagious for 3 days.

Influenza is usually a self-limited disease that lasts from 2 to 7 days. The disease also spreads rapidly through populations, creating epidemics and pandemics.
Complications of influenza include:
• Pneumonia,
• Myositis,
• Exacerbation of chronic obstructive pulmonary disease (COPD),
• Reye’s syndrome.
In rare cases, influenza can lead to encephalitis, transverse myelitis, myocarditis, or pericarditis.

Causes:

Influenza is caused by three main types of influenza virus called A, B, and C, and is common. A new vaccine is developed annually to fight the most common strains, and yearly vaccination is important, particularly for those at risk of complications, including people over 65 and those with other health issues.

Heritable immune responses could be protective or increase susceptibility The incidence of influenza cases is highest in school-age children and generally decreases with age, probably because of immunity established by repeated infections as people age. During an outbreak of the disease, however, elderly persons and those disabled by chronic illnesses are most likely to develop severe complications. Males and females of all races and ethnicities are equally susceptible. During the third trimester of pregnancy, women are at high risk for complications of influenza A and B.

Symptoms

Symptoms include a high fever, muscle aches and pains, coughing, sneezing, sweats, shivers, and exhaustion. It typically lasts a week, but fatigue may persist. Complications include pneumonia, bronchitis, meningitis, and encephalitis

Nursing Assessment:

• Acute onset of fever and muscle aches
• Headache
• Fatigue, weakness, anorexia
• Sore throat, cough, and rhinorrhea

HISTORY. Determine if the patient has had contact with an infected person within the past 72 hours. Ask about immunization. Establish a history of fever and chills, hoarseness, laryngitis, sore throat, rhinitis, or rhinorrhea. Elicit a history of myalgia (particularly in the back and limbs), anorexia, malaise, headache, or photophobia. Ask if the patient has a nonproductive cough; in children, the cough is likely to be croupy. Determine if the patient has experienced gastrointestinal symptoms, such as vomiting and diarrhea.

Examine to Influenza Patient:

Observe the patient for a flushed face and conjunctivitis. When you inspect the patient’s throat, you may note redness of the soft palate, tonsils, and pharynx. Palpate for enlargement of the anterior cervical lymph nodes. The patient’s temperature usually ranges from 102°F to 103°F and often rises suddenly on the first day before falling and rising again on the third day of illness. Check if influenza has produced respiratory complications. Note the patient’s rate of respirations, which may be increased. Auscultate the patient’s lungs for rales.

Diagnosis Process

General Comments: No specific diagnostic tests are used because diagnosis is made by the history of symptoms and onset. If the patient has symptoms of a bacterial infection that complicates influenza, cultures and sensitivities may be required.

Primary Nursing Diagnosis

Infection related to the presence of virus in mucus secretions
OUTCOMES. Immune status; Knowledge: Infection control; Risk control; Risk detection; Nutrition status; Treatment behavior: Illness or injury; Hydration; Knowledge: Infection control.
INTERVENTIONS. Infection control; Infection protection; Surveillance; Fluid/electrolyte.
management; Medication management; Temperature regulation.

Influenza Treatment:

Pharmacologic Treatment,
General Comments: Phenylephrine and antitussive agents such as terpin hydrate with codeine are often prescribed to relieve nasal congestion and coughing. In patients with influenza that is complicated by pneumonia, antibiotics may be administered to treat a bacterial superinfection.
Drugs used in Influenza Treatment:
• Antipyretics
• Amantadine

Other Drugs: Neuraminidase inhibitors (oseltamivir and zanamivir) for use in treatment and prophylaxis of influenza A and B; rimantadine for treatment and prophylaxis of influenza A only; antiviral treatment should be initiatied within 48 hours of the onset of symptoms to be effective.

Discharge and Home Healthcare Guidelines:

PREVENTION. To prevent complications, emphasize to the patient the need to maintain bedrest and high fluid intake for 2 to 3 days after the temperature returns to normal.

MEDICATIONS. Instruct the patient and family about the dosage, route, action, and side effects of all medications.
COMPLICATIONS. Instruct the patient and family to report any chest pain, ear pain, or change in respirations to the physician.