Nursing Care Plan (NCP) for Influenza

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Outline

Pathophysiology

Influenza, commonly known as “the flu”, is an infectious disease caused by an influenza virus. Influenza is spread by droplets in the air or by transferring droplets from surfaces to mucus membranes (like the eyes, nose, mouth, and throat). Therefore, its primary symptoms are respiratory or systemic in nature. Occasionally it can cause gastroenteritis with vomiting – commonly known as the “stomach flu”.

Etiology

There are multiple strains of the influenza virus affecting both humans (A, B, and C) and animals (swine, avian).

Desired Outcome

To prevent respiratory distress and support symptoms so the patient can return to baseline level of health.

Influenza Nursing Care Plan

Subjective Data:

  • Shortness of breath
  • Fatigue
  • Muscle aches
  • Headache
  • Reports cough, runny nose, sore throat
  • Reports sudden onset
  • Reports vomiting

Objective Data:

  • High fever (102-104°F)
  • Productive cough
  • Vomiting
  • Positive flu swab

Nursing Interventions and Rationales

  • Screen patients for vaccine necessity and administer as appropriate
    • No contraindications
    • Provide VIS sheet
    • Document if received or declined

 

  • The best method for managing influenza is to prevent it in the first place. The flu vaccine is the best method to prevent the flu.
  • Ensure they meet indications and have no contraindications (allergy to eggs or latex, history of Guillain-Barre, recent bone marrow or organ transplant) to avoid complications.  
  • Always educate the patient on the possible side effects (injection site pain, runny nose) and provide the VIS sheet so they can read it.
  • Always document the details of the vaccine (lot number, expiration, etc.). OR document if they declined.

 

  • Maintain droplet precautions if hospitalized

 

Influenza is spread via droplets. Should wear gloves and a simple mask and use good hand hygiene

 

  • Assess lung sounds

 

Influenza primarily affects the respiratory system. Monitor for any changes in lung sounds that might indicate decompensation.

 

  • Monitor oxygenation and give supplemental O2 as needed

 

Influenza primarily affects the respiratory system. Patients may struggle to oxygenate appropriately because of mucus buildup. Support oxygenation as appropriate (caution in COPD patients).

 

  • Monitor for signs of sepsis or septic shock (increasing fever, decreasing blood pressure)

 

Influenza can escalate quickly, especially in immunocompromised patients. Monitor vital signs frequently to detect and signs of sepsis. Catching it early can improve outcomes

 

  • Encourage nutrition – small, frequent meals if needed – or nutrient dense options

 

Patients may lose their appetite or be too fatigued to eat. Proper nutrition can promote faster healing. It’s important to encourage them to eat, even if small meals.

Nutrient dense options like Boost shakes or Magic Cups can provide more protein in a smaller amount

 

  • Administer IV fluids and/or encourage PO intake

 

Because of the high fever and poor PO intake, patients can often get dehydrated. Providers may order maintenance IV fluids. If not, encourage PO intake of fluids to maintain proper hydration.

 

  • Educate patient and family on prevention of spread
    • Hand-hygiene
    • Cover cough
    • Don’t touch eyes, nose, mouth
    • Avoid public gatherings if symptomatic

 

Influenza is highly contagious. Preventing the spread to other patients is the purpose of our droplet precautions. However, it is important to educate the patient and family so that friends and family members don’t contract the flu or spread it to others.

Hand hygiene is the #1 way to prevent spread of influenza.

 

  • Administer antivirals as ordered

 

Oseltamivir (Tamiflu) is most effective when given within 48 hours of onset of symptoms. Educate patients on possible side effects.

Writing a Nursing Care Plan (NCP) for Influenza

A Nursing Care Plan (NCP) for Influenza starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.


References

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Transcript

All right. Today, we are going to be talking about influenza. The flu is pretty much caused by the influenza virus. It is easily spread with droplets in the air and also picks up droplets from a surface like a tabletop or counter. Most of its symptoms are respiratory. So you’re gonna think about coughing, sneezing, fevers. One thing that we want to take into consideration as nurses is we want to make sure that we encourage fluids; PO fluids, if possible. Because these patients are sick, they don’t want to drink, and they tend to get dehydrated. We want to make sure that we administer medication. So any antivirals that are ordered antibiotic or any insets, and then we want to make sure that we place these patients on droplet precautions because the flu is very contagious. Our desired outcome is to prevent respiratory distress and we want to support the symptoms so that the patient can return to their baseline. 

When a patient comes in with the flu, one of the main things that they are going to complain about is shortness of breath and fatigue. The flu is known for causing weakness. So we want to say weakness and fatigue. Okay. The next thing that the patient is going to complain about is muscle aches. You hear a lot of fullness in the head, cough, runny nose, sore throat, and vomiting, are some things that we’re going to notice. Some objective data that we’re going to notice as we’re going to notice a fever, but not just a fever, a high fever, ranging from one or two to 1 0 4. We’re going to also see a productive cough. So there’s going to be some sputum produced as well. And the definitive diagnosis for the flu is going to come from a positive flu swab. And typically those are done in the emergency room once they present with these symptoms. 

Some nursing interventions that we want to be mindful of are right when we find out that the patient or we suspect that the patient has flu, we want to initiate contact droplet precautions, because the flu is spread via droplets. So we want to make sure that we wear gloves and a face mask and make sure we use really good hand hygiene. The next thing that we want to focus on is we want to look at the vital signs, but more importantly, we want to take a look at their oxygenation because often times we may have to administer O2 because the patient may start to decline, especially those patients who are in those high risk categories, such as COPD patients or  PE patients with asthma, any other type of pre-existing conditions. We want to be mindful of them too, because they may find it difficult to breathe. 

There are some medications that we can give to kind of help shorten the flu, the most known one that we’re going to talk about. It’s an antiviral and it’s called Tamiflu. And that just pretty much, I think they said, it shortens it to like five days, which is great, but you want to make sure to just give them within 48 hours. And then we want to make sure we educate patients on any possible side effects. Next we want to educate the patient and the family on how to stop the spread because the flu is so contagious. We want to make sure we can end the spreading as soon as possible. And that’s going to include measures such as hand hygiene. And then we also want to make sure if the patient is sick, that they avoid public gatherings, and use the coughing into the elbow method if they are coughing. 

And, finally we want to encourage nutrition. Oftentimes these patients do not have to be hospitalized, but if you’re taking care of someone that’s hospitalized, whether they’re discharged, we want to encourage nutrition. So we want to make sure that they are drinking and if they can’t eat, maybe, maybe they can have some supplements such as a boost shake or magic cups just to provide more nutrients that’s calories, just in a smaller amount. Okay, some of the key points that we are going to focus on here is that remember influenza is spread by respiratory droplets. So anything coughing, those droplets can land on the table. So you want to make sure that you’re doing some really good hand hygiene, okay. Shortness of breath, fatigue, weakness, muscle aches. Those are some of the things that the patients will tell you. 

Some of the subjective data, some of the objective things that we’re going to see is a high fever, a one or two to 1 0 4, a positive flu swab, and also a productive cough. Antivirals are going to need to be administered within 48 hours of the onset of symptoms. So the one that is most widely used is Tamiflu, and then we go to one to prevent the spread. The number one way to prevent the spread of the influenza virus is by washing your hands. Okay. I hope that this presentation was really good for you. We love you guys; go out and be your best self today and, as always, happy nursing.

 

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