Valdez Jansen Ira E.
BSN 1D
7B DISCISSION FORUM
MEDICAL CONDITION MANIFESTATIONS (3)
INFLUENZA • The sudden onset of constitutional
and upper respiratory tract signs and
symptoms is characteristic of influenza
illness (e.g., fever, chills, myalgia,
headache, malaise, nonproductive
cough, sore throat, and rhinitis).
• Many people who are infected with
the influenza virus do not develop a
fever, particularly the elderly and
immunocompromised.
• Atypical signs and symptoms of
influenza virus infection can occur,
including in frail, institutionalized
elderly long-term care facility residents.
Among young children with influenza,
nausea, vomiting or diarrhea may also
occur with respiratory symptoms.
DENGUE • some people develop severe dengue,
which can be any number of
complications associated with severe
bleeding, organ impairment and/or
plasma leakage .
• Dengue should be suspected when a
high fever (40°C/104°F) is accompanied
by 2 of the following symptoms during
the febrile phase:( severe, headache,
pain behind the eyes, muscle and joint
NURSING INTERVENTIONS (5) with
CORRESPONDING RATONALES
• Assess respiratory status for rate,
depth, ease, use of accessory muscles,
and work of breathing. Changes may
vary from minimal to extreme caused
by bronchial swelling, increased mucus
secretions caused by oversecretion of
goblet cells and tracheobronchial
infection, narrowing of air passageways,
and presence of other disease states
that complicates the current condition.
• Auscultate the lung fields for the
presence of wheezes, crackles (rales),
rhonchi, or decreased breath sounds.
Wheezing is caused by squeezing of air
past the narrowed airways during
expiration which is caused by
bronchospasms, edema, and secretions
obstructing the airways. Crackles or
rales, result from consolidation of
leukocytes and fibrin in the lung causing
an infection or by fluid accumulation in
the lungs. Decreased breath sounds
may indicate alveolar collapse with little
to no air exchange in the lung area
being auscultated and usually results in
poor ventilation.
• Administer oxygen as ordered.
Monitor oxygen saturation by pulse
oximetry, and notify the physician of
readings
• Blood pressure monitoring. Measure
blood pressure as indicated.
• Monitoring pain. Note client report of
pain in specific areas, whether pain is
increasing, diffused, or localized.
• Vascular access. Maintain patency of
vascular access for fluid administration
or blood replacement as indicated.
• Medication regimen. There must be a
 pains).
• It is at this time, when the fever is
dropping (below 38°C/100°F) in the
patient, that warning signs associated
with severe dengue can manifest.
HEPATITIS • People can get Hepatitis by
contaminated food or water or from
close contact with a person or object
that's infected
• be relatively mild and go away in a
few weeks. Sometimes, however,
hepatitis A infection results in a severe
illness that lasts several months.
• Hepatitis A can cause a sudden loss of
liver function, especially in older adults
or people with chronic liver diseases.
Acute liver failure requires a stay in the
hospital for monitoring and treatment.
Some people with acute liver failure
may need a liver transplant.
RABIES • Flu -like symptoms. The first
symptoms of rabies may be very similar
periodic review of the medication
regimen of the client to identify
medications that might exacerbate
bleeding problems.
• Fluid replacement. Establish 24 -hour
fluid replacement needs.
• Monitor dietary intake and caloric
count. Suggest several small feedings
and offer “largest” meal at breakfast.
Large meals are difficult to manage
when patient is anorexic. Anorexia may
also worsen during the day, making
intake of food difficult later in the day. •
Encourage mouth care before meals.
Enhances appetite by eliminating
unpleasant taste.
• Encourage intake of fruit
juices,carbonated beverages, and These
supply extra calories and may be more
easily digested or tolerated than other
foods.
• Consult with dietitian, nutritional
support team to provide diet according
to patient’s needs, with fat and protein
intake as tolerated. Useful in
formulating dietary program to meet
individual needs. Fat metabolism varies
according to bile production and
excretion and may necessitate
restriction of fat intake if diarrhea
develops. If tolerated, a normal or
increased protein intake helps with liver
regeneration. Protein restriction may be
indicated in severe disease (fulminant
hepatitis) because the accumulation of
the end products of protein metabolism
can potentiate hepatic encephalopathy.
• Monitor serum glucose as indicated .
Hyperglycemia or hypoglycemia may
develop, necessitating dietary changes
and insulin administration. Fingerstick
monitoring may be done by patient on a
regular schedule to determine therapy
needs.
• Improve breathing pattern. Place
patient with proper body alignment for
to those of the flu including general
weakness or discomfort, fever, or
headache; these symptoms may last for
days.
• Hydrophobia and aerophobia.
Hydrophobia and aerophobia are
pathognomonic for rabies and occur in
50% of patients; attempting to drink or
having air blown in the face produces
severe laryngeal or diaphragmatic
spasms and a sensation of asphyxia; this
may be related to a violent response of
the airway irritant mechanisms; even
the suggestion of drinking may induce
hydrophobic spasm.
• Psychologic symptoms. As the disease
progresses, the person may experience
delirium, abnormal behavior,
hallucinations, insomnia, anxiety,
confusion, and agitation.
maximum breathing pattern; maintain a
clear airway by encouraging patient to
mobilize own
secretions with successful coughing;
suction secretions, as necessary; and
encourage frequent rest periods and
teach patient to pace activity.
• Improve nutritional intake. Provide a
pleasant environment; promote proper
positioning; provide good oral hygiene
and dentition; consider six small
nutrient-dense meals instead of three
larger meals daily to lessen the feeling
of fullness; for patients with impaired
swallowing, coordinate with a speech
therapist for evaluation and instruction;
determine time of day when the
patient’s appetite is at peak and offer
highest calorie meal at that time.
• Maintain normal body temperature.
Adjust and monitor environmental
factors like room temperature and bed
linens as indicated; eliminate excess
clothing and covers; and give antipyretic
medications as prescribed.
• Reduce anxiety. Use presence, touch
(with permission), verbalization, and
demeanor to remind patients that they
are not alone and to encourage
expression or clarification of needs,
concerns, unknowns, and questions;
interact with patient in a peaceful
manner; accept patient’s defenses; do
not dare, argue, or debate; converse
using a simple language and brief
statements; and explain all activities,
procedures, and issues that involve the
patient; use nonmedical terms and
calm, slow speech.
• Prevent injury. Avoid use of
restraints; obtain a physician’s order if
restraints are needed; if patient has a
new onset of confusion (delirium),
render reality orientation when
interacting with him or her; ask family
or significant others to be with the
patient to prevent him or her from

HIV/AIDS • Constitutional symptoms. Fever more
than 38.5⁰C or diarrhea exceeding 1
month in duration may also indicate
presence of HIV infection.
• Patients with HIV category C
experience wasting syndrome or severe
wasting of the muscles.
• Swollen lymph nodes — often one of
the first signs of HIV infection
CoVID -19 • Fever
• Dry cough
• Shortness of breath
• Bowel Movement
• Fatigue
accidentally falling; eliminate or drop all
possible hazards in the room such as
razors, medications, and matches; and
place an injury -prone patient in a room
that is near the nurses’ station.
• Promote skin integrity. Patients are
encouraged to avoid scratching; to use
nonabrasive, nondrying soaps and apply
nonperfumed moisturizers; to perform
regular oral care; and to clean the
perianal area after each bowel
movement with nonabrasive soap and
water.
• Promote usual bowel patterns. The
nurse should monitor for frequency and
consistency of stools and the patient’s
reports of abdominal pain or cramping.
• Prevent infection. The patient and the
caregivers should monitor for signs of
infection and laboratory test results
that indicate infection.
• Improve activity intolerance. Assist
the patient in planning daily routines
that maintain a balance between
activity and rest.
• Maintain thought processes. Family
and support network members are
instructed to speak to the patient in
simple, clear language and give the
patient sufficient time to respond to
questions.
• Monitor vital signs. Monitor the
patient’s temperature; the infection
usually begins with a high temperature;
monitor the respiratory rate of the
patient as shortness of breath is
another common symptom.
• Monitor O2 saturation. Monitor the
patient’s O2 saturation because
respiratory compromise results in
hypoxia.
• Maintain respiratory isolation. Keep
tissues at the patient’s bedside; dispose
secretions properly; intsruct the patient
to cover mouth when coughing or
sneezing; use masks, and advise those

MEASLES • High fever. The first sign of measles is
usually a high fever (often >104o F [40o
C]) that typically lasts 4 -7 days.
• Prodromal phase symptoms. This
prodromal phase is marked by malaise,
fever, anorexia, and the classic triad of
conjunctivitis, cough, and coryza (the “3
Cs”).
• Exanthem. The characteristic
exanthem generally appears 2 -4 days
after the onset of the prodrome and
lasts 3-5 days; the exanthem usually
appears 1 -2 days after the appearance
of Koplik spots; mild pruritus may be
associated, on average, the rash
develops about 14 days after exposure,
starting on the face and upper neck
(see the image below) and spreading to
the extremities.
POLIO • Nonspecific symptoms. Fever,
headache, nausea, vomiting, abdominal
pain, and oropharyngeal hyperemia are
observed in mild cases and usually
entering the room to wear masks as
well; place respiratory stickers on chart,
linens, and so on.
• Enforce strict hand hygiene. Teach the
patient and folks to wash hands after
coughing to reduce or prevent the
transmission of the virus.
• Manage hyperthermia. Use
appropriate therapy for elevated
temperature to maintain normothermia
and reduce metabolic needs.
• Isolation. Patients will need to be on
isolation precautions to decrease
transmission within the community;
emphasize the need for immediate
isolation when early catarrhal
symptoms appear.
• Skin care. Measles causes extreme
pruritus; nursing interventions include
keeping the patient’s nails short,
encourage long pants and sleeves to
prevent scratching, keeping skin moist
with health care provider
recommended lotions, and avoiding
sunlight and heat.
• Eye care. Treat conjunctivitis with
warm saline when removing eye
secretions and encourage patient not to
rub eyes; protect the eyes from the
glare of strong light.
• Hydration. Encourage oral hydration;
medical literature encourages the use
of oral rehydration solution.
• Temperature control. Antipyretics
should be administered to the patient
as ordered for a temperature greater
than 100.4 Fahrenheit unless directed
elsewise by a healthcare provider; be
sure to remind parents not to
administer aspirin due to the risk of
Reye’s syndrome.
• Nutrition. Encourage frequent small
meals to promote nutritional and fluid
intake; maintain nasogastric tube
feeding, if ordered; hyperalimentation
 resolve within a few days.
• Nonparalytic poliomyelitis.
Nonparalytic poliomyelitis is
characterized by the symptoms
described above in addition to the
following: nuchal rigidity, more severe
headache, back, and lower extremity
pain, and meningitis with lymphocytic
pleocytosis (usually). • Numbness, a
feeling of pins and needles or tingling in
the legs or arms.
REFERENCES
CDC.(2020). Clinical Signs and Symptoms of Influenza. Retrieved from
https://www.cdc.gov/flu/professionals/acip/clinical.htm
may be necessary to ensure adequate
nutrition and eliminate unpleasant
odors from the environment during
meals.
• Thermoregulation. Reduce or
eliminate the sources of heat loss in
infants and monitor the body
temperature.
• Airway clearance. Assess respiratory
rate, rhythm, depth, effort, and breath
sounds; and elevate the head of the
bed to promote the optimum level of
activity for best possible lung
expansion.
• Physical assessment. Observe the
client for possible signs and symptoms
of polio as listed above.
• Pain. Administer analgesics as
prescribed and educate the patient on
diversional activities to reduce the pain.
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WHO. (2020).Dengue and severe dengue.Retrieved From https://www.who.int/news-room/factsheets/detail/dengue-

and-severedengue#:~:text=Dengue%20is%20a%20mosquito%2Dborne,Asian%20and%20Latin%20American%20cou
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Mayo Clinic. Hepatitis A .(2020).Retrieved from https://www.mayoclinic.org/diseasesconditions/hepatitis-a/symptoms-

causes/syc-20367007

Vera. (2019). 7 Hepatitis Nursing Care Plans. Retrieved fromhttps://nurseslabs.com/7-hepatitis-nursingcare-plans/

Belleza. (2021). Rabies. Retrieved from https://nurseslabs.com/rabies/#google_vignette Belleza. (2021). Human

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Belleza.(2021). Measles (Rubeola).Retrieved from https://nurseslabs.com/measles/#:~:text=Despite%20being

%20considered%20primarily%20a,the%20thi rd%20to%20seventh%20day.

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%20polio%20include,and%20pain%20i n%20the%20limbs.