LEGEND:

Disease Predisposing Factors Precipitating Factors

Disease Process Signs and Symptoms Nursing Diagnosis

Nursing Management Medical Management Diagnostic Tests and Findings

Exposure to individuals
Age: 44 Years Old with the same symptoms
Hypertension Corona Virus Disease BMI: 26.5 - Overweight
Diabetes Type 2 Current Smoker

Possible exposure to COVID infected individual

HCTZ Lisinopril

SARS-CoV-2 virus binds to the ACE 2 receptor

Metformin

Loss of Sense
of Smell Nasal epithelial Inside the alveoli
cells Gustatory Gastrointestinal
Epithelial cells Epithelial cells Nausea

Nasal Decreased
Congestion Coryza Appetite Diarrhea

Increases Vascular cell adhesion

molecule (VCAM-1)
Replication of the virus inside the cells

Pulls WBCs into the area

Cell death caused by exocytosis of the virus
of inflammation

Releases damage-associated
Exacerbates inflammatory molecular patterns (DAMPs)
Dizziness
response (Cytokine storm)

Alerts the the macrophage

Impairs lymphopoiesis SIRS to secrete cytokines
(IL-1, IL-6, IL-8, TNF-alpha, IFN-delta)
1+ peripheral pulses,
Hypercoagulability slight delayed
capillary refill
 Leukopenia
WBC: 2.6 x 10^9/L

Cytokines, specifically IL-1 and TNF-alpha, Increases permeability of the

acts on the hypothalamus cell membranes

B-lines in the lung

Increased prostaglandin Interstitial edema
ultrasound
production Activates Neutrophils

Alveolar edema
Diffused body Fever: 39.2C
aches

Acetaminophen Thickens the alveolar membrane

Hyperthermia

Decrease in PaO2
Monitor Vital Sign
Maintain bedrest, ambulate as needed
Releases reactive oxygen species and
Remove excess clothing and covers
proteases to attack the cause of
Provide tepid sponge bath inflammation
Raise patient’s side rails at all times
Administer antipyretics as prescribed

Triggers chemoreceptors to
Increased RR activate the Sympathetic
22 cpm nervous system

Increased HR
Bronchospasm 140 bpm

Hypoxemia Impaired Gas Exchange Damages healthy alveolar cells

Salbutamol + Ipratropium

Assess respiratory status(rate, rhythm, depth, sounds)

Shortness of Breath
Nasal Cannula Oxygen
@ 3LPM
Assess for cyanosis, changes in mentation, stress, and anxiety
Assist the patient in an upright (30 to 45 degrees) position as their
condition allows
Provide small frequent meals and add supplements
Provide rest periods between ADLs and pace activities.
Turn and reposition the patient at least every two hours
Encourage or assist with ambulation as indicated and tolerated
 Releases cytokines

Activates the chemoreceptors

Sloughing of of dead cells to Decrease in Decrease in connected to the Vagus nerve
the center of the alveoli Type 2 Pneumocytes Type 1 Pneumocytes

Cough reflex
Decrease in gas
Accumulation of fluids, cell Decrease in the exchange
debris, and white blood cells production of surfactants
Dry cough or
productive cough
Hypoxemia
Crackles Consolidation Increase surface
Orthopnea
tension

X-ray and CT scan Light

headedness
Alveolar collapse

Shortness of Breath Chest Pain

Ineffective Airway Clearance

Impaired Gas Exchange

Assess respiratory status(rate, rhythm, depth, sounds)

Monitor ABG values, hemoglobin levels, skin color and mucus
membranes, and level of consciousness
Monitor sputum, noting amount, odor, consistency, and ease of
expectoration
Assist the patient to an optimal upright position
Encourage adequate fluid intake, if not contraindicatedEncourage the
client to cough and deep breathe; splinting while coughin
Turn and reposition the patient at least every two hours
Perform nasotracheal suctioning as necessary, especially if cough is
ineffective.