severe acute respiratory distress syndrome

1
13-5 www. SimpleNursing.com Severe acute respiratory distress syndrome What am i ? Mild, moderate, or severe viral respiratory infection caused by a distinct coronavirus. It is Believed to be less infectious than the influenza virus. Incubation period estimated to range from 2 to 10 days . Not highly contagious when protective measures are taken Currently no known transmission worldwide. Two stages Stage 1 : involving flu like symptoms that begin 2 to 7 days after incubation and last 3 to 7 days Stage 2: involving the lower respiratory tract Patho Coronaviruses cause diseases in pigs, birds, and other animals. A theory suggests that a coronavirus may have mutated, allowing transmission to and infection of humans-(SARS-associated coronavirus [SARS-CoV]). Mucous membranes come in direct or indirect contact with infectious respiratory droplets or fomites. The virus attaches itself to human receptor cells, initiating a nonspecific acute lung injury. The result is diffuse, severe, alveolar damage. Causes Coronavirus known as SARS-associat ed coronavirus (SARS-CoV) Assessment Contact with a person known to have SARS. Travel to an endemic area. Flu like signs and symptoms; initially no respiratory signs or symptoms during the first 3 to 7 days, then a nonproductive cough. RESP: Dry cough, Dyspnea, Tachypnea, Rhinorrhea, Crackles, Respiratory distress in later stages GI/GU: Diarrhea,Nausea and vomiting,Sore throat, MS: Myalgias DERM: Rash MISC: Fever and chills, Headache, Fatigue,Malaise, Anorexia O: Out of country U: Undeveloped countries T: Travel to endemic areas O: Out of breath F: Fever, fatigue B: Bad muscle aches ( myalgias) R: Rhinorrhea Respiratory distress E: Excess vomiting A: A sore throat/ T: Tachypnea H: Headache Labs & Diagnostics Antibody testing with enzyme-linked immunosorbent assay and the immunofluorescent antibody test confirm diagnosis. Sputum culture isolates coronavirus. Complete blood count may show leucopenia and thrombocytopenia. Liver transaminase level and lactate dehydrogenase test results may be elevated as may creatine kinase levels. SARS-specific polymerase chain reaction test detects SARS-CoV ribonucleic acid. Blood culture identifies the infection. Chest radiography may be normal or may reveal diffuse interstitial infiltrates or bilateral peripheral infiltrates. Computed tomography scanning (thorax) may reveal infiltrates that resemble ground glass or may reveal obvious consolidation. Interventions Symptomatic treatment Airborne and contact precautions Negative-pressure single room for hospitalized patients Strict respiratory and mucosal barrier precautions, including an N95 respirator Quarantine of exposed people to prevent the spread of the virus Global surveillance and reporting of suspected cases to national health authorities Intubation and mechanical ventilation, if indicated Venous thromboembolism (VTE) prophylaxis Treatments Antivirals: ribavirin (Virazole) or oseltamivir phosphate (Tamiflu) (not proven consistently effective) Combination of steroids and antimicrobials (not proven consistently effective) Interferon alfacon-1 (not proven consistently effective) Oxygen therapy IV fluid supplementation Education Educate on disease process Measures to prevent spread of infection Hand hygiene Not sharing utensils Educate on treatment regimen. Educate on the importance of follow up care.

Upload: others

Post on 28-Feb-2022

3 views

Category:

Documents


0 download

TRANSCRIPT

13-5

www. SimpleNursing.com

Severe acute respiratory distress syndrome What am i ?

Mild, moderate, or severe viral respiratory infection caused by a distinct coronavirus. It is Believed to be less infectious than the influenza virus. Incubation period estimated to range from 2 to 10 days .Not highly contagious when protective measures are taken Currently no known transmission worldwide.

Two stages❖ Stage 1 : involving flu like

symptoms that begin 2 to 7 days after incubation and last 3 to 7 days

❖ Stage 2: involving the lower respiratory tract

Patho Coronaviruses cause diseases in pigs, birds, and other animals. A theory suggests that a coronavirus may have mutated, allowing transmission to and infection of humans-(SARS-associated coronavirus [SARS-CoV]). Mucous membranes come in direct or indirect contact with infectious respiratory droplets or fomites. The virus attaches itself to human receptor cells, initiating a nonspecific acute lung injury. The result is diffuse, severe, alveolar damage.

Causes❖ Coronavirus

known as SARS-associated coronavirus (SARS-CoV)

Assessment Contact with a person known to have SARS. Travel to an endemic area. Flu like signs and symptoms; initially no respiratory signs or symptoms during the first 3 to 7 days, then a nonproductive cough.RESP: Dry cough, Dyspnea, Tachypnea, Rhinorrhea, Crackles, Respiratory distress in later stagesGI/GU: Diarrhea,Nausea and vomiting,Sore throat,MS: MyalgiasDERM: RashMISC: Fever and chills, Headache, Fatigue,Malaise, Anorexia

O: Out of country U: Undeveloped countriesT: Travel to endemic areas

O: Out of breath F: Fever, fatigue

B: Bad muscle aches ( myalgias) R: Rhinorrhea Respiratory distressE: Excess vomitingA: A sore throat/ T: TachypneaH: Headache

Labs & Diagnostics ❖ Antibody testing with enzyme-linked

immunosorbent assay and the immunofluorescent antibody test confirm diagnosis.

❖ Sputum culture isolates coronavirus.❖ Complete blood count may show leucopenia and

thrombocytopenia.❖ Liver transaminase level and lactate

dehydrogenase test results may be elevated as may creatine kinase levels.

❖ SARS-specific polymerase chain reaction test detects SARS-CoV ribonucleic acid.

❖ Blood culture identifies the infection.❖ Chest radiography may be normal or may reveal

diffuse interstitial infiltrates or bilateral peripheral infiltrates.

❖ Computed tomography scanning (thorax) may reveal infiltrates that resemble ground glass or may reveal obvious consolidation.

Interventions ❖ Symptomatic treatment❖ Airborne and contact precautions❖ Negative-pressure single room for

hospitalized patients❖ Strict respiratory and mucosal barrier

precautions, including an N95 respirator❖ Quarantine of exposed people to prevent

the spread of the virus❖ Global surveillance and reporting of

suspected cases to national health authorities

❖ Intubation and mechanical ventilation, if indicated

❖ Venous thromboembolism (VTE) prophylaxis

Treatments ● Antivirals: ribavirin (Virazole) or

oseltamivir phosphate (Tamiflu) (not proven consistently effective)

● Combination of steroids and antimicrobials (not proven consistently effective)

● Interferon alfacon-1 (not proven consistently effective)

● Oxygen therapy● IV fluid supplementation

Education ❖ Educate on disease process❖ Measures to prevent spread of

infection❖ Hand hygiene ❖ Not sharing utensils❖ Educate on treatment regimen. ❖ Educate on the importance of

follow up care.