E.

Nursing Management (Highlight the Priority Nursing Interventions)

Nursing interventions for corona virus disease should focus on monitoring vital signs,
maintaining respiratory function, managing hyperthermia, and reducing transmission.

Monitor vital signs – particularly temperature and respiratory rate, as fever and dyspnea are
common symptoms of COVID-19.

Monitor O2 saturation – normal O2 saturation as measured with pulse oximeter should be 94

or higher; patients with severe COVID-19 symptoms can develop hypoxia (low levels of oxygen
in your body tissues), values dropping 94% and below are warranted with supplemental oxygen.

Manage fever – we can do this by adjusting room temperature, performing tepid sponge bath,
and administering antipyretic medications as prescribed.

Maintain respiratory isolation – (this is to prevent the spread of the deadly virus) isolation
rooms should be well-marked with limited access; all who enter the restricted-access room for
example the nurses and doctors who are in charge of the patient should use personal protective
equipment, such as masks and gowns.

Enforce strict hand hygiene – to reduce or prevent transmission of coronavirus, patients should
wash hands after coughing, as should all who enter or leave the room.

Provide information – educate the patient and patient’s family members about coronavirus
disease, the transmission of the disease, the tests to diagnose the disease, the disease process,
possible complications, and ways to protect oneself and one’s family from coronavirus.

https://everynurse.org/nursing-management-covid-19/
F. Pharmacologic management and nursing responsibilities

The FDA has authorized certain antiviral medications and monoclonal antibodies to treat
mild to moderate COVID-19 in people who are more likely to get very sick.

ANTIVIRAL TREATMENT:
Nirmatrelvir with Ritonavir (Paxlovid)

Paxlovid consists of nirmatrelvir, which works by inhibiting the SARS-CoV-2 protein to

stop the virus from replicating, and ritonavir, which slows down nirmatrelvir’s
breakdown to help it remain in the body for a longer period at higher concentrations.
Paxlovid is administered as three tablets (two tablets of nirmatrelvir and one tablet of
ritonavir) taken together orally twice daily for five days, for a total of 30 tablets. Paxlovid
is not authorized for use for longer than five consecutive days.

Nursing responsibilities:
- Strictly co-administer 300 mg nirmatrelvir and100 mg ritonavir PO BID x 5 days
- Do not crush or do not let patient chew the drug as it may disrupt its therapeutic effect.
- If hypersensitivity reactions reported like dyspnea and angioedema (swelling underneath
the skin. It's usually a reaction to a trigger, such as a medicine or something you're
allergic to.), cease provision and inform the physician.

https://reference.medscape.com/drug/paxlovid-nirmatrelvir-ritonavir-4000259#5
https://www.fda.gov/media/155050/download\

ANTICLONAL ANTIBODIES:
Bebtelovimab

Bebtelovimab works by binding to the spike protein of the virus that causes COVID-19,
similar to other monoclonal antibodies that have been authorized for the treatment of
high-risk patients with mild to moderate COVID-19.

Nursing responsibilities:
- Remove vial from refrigerator and allow to equilibrate to room temperature for ~20
minutes; do not expose to direct heat
- Do not shake vial
- Inspect vial visually for particulate matter and discoloration
- Withdraw 2 mL (175 mg) from vial into disposable syringe
 GLUCOCORTICOSTEROID

For patients who have severe cases of coronavirus disease (COVID-19), we can
administer dexamethasone.

Dexamethasone is a corticosteroid that can help reduce the length of time on a ventilator
and save lives of patients with severe and critical illness.

Nursing responsibilities:
- Monitor intake and output ratios and daily weights.
- Observe patient for appearance of peripheral edema
- Notify physician if there’s steady weight gain, rales/crackles or dyspnea

https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html
G. Medical Procedures/Management

Management of mild COVID-19: symptomatic treatment

Patients with suspected or confirmed mild COVID-19 be isolated to contain virus

transmission. This can be done at a designated COVID-19 health facility, community
facility, or at home (self-isolation). Such patients can be given treatments such as
antipyretics for fever and pain, adequate nutrition, and appropriate rehydration.

Management of moderate COVID-19: pneumonia treatment

Patients with suspected or confirmed moderate COVID-19 (pneumonia) be isolated to

contain virus transmission. Patients with moderate illness may not require emergency
interventions or hospitalization; however, isolation is necessary for all suspect or
confirmed cases.
Management of severe COVID-19: severe pneumonia treatment
Immediate administration of supplemental oxygen therapy to any patient with emergency
signs during resuscitation to target SpO2 ≥ 94% and to any patient without emergency
signs and hypoxemia (i.e., stable hypoxemic patent) to target SpO2 > 90% or ≥ 92–95%
in pregnant women.
H. Surgical Management (if there are any)

N/A
References:
Centers for Disease Control and Prevention. (2022, August 5). COVID-19 Treatments and Medication.
Retrieved from Centers for Disease Control and Prevention:
https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

Hetzler, L. (2020, July 10). Nursing Management for Patients with COVID-19. Retrieved from everynurse:
https://everynurse.org/nursing-management-covid-19/

World Health Organization. (2022, September 15). Clinical management of COVID-19. Retrieved from
World Health Organization: https://www.who.int/teams/health-care-readiness/covid-19

References
Centers for Disease Control and Prevention. (2022, August 5). COVID-19 Treatments and Medication.
Retrieved from Centers for Disease Control and Prevention:
https://www.cdc.gov/coronavirus/2019-ncov/your-health/treatments-for-severe-illness.html

FDA. (2021, December 22). Coronavirus (COVID-19) Update: FDA Authorizes First Oral Antiviral for
Treatment of COVID-19. Retrieved from FDA: https://www.fda.gov/news-events/press-
announcements/coronavirus-covid-19-update-fda-authorizes-first-oral-antiviral-treatment-
covid-19

FDA. (2022, February 11). Coronavirus (COVID-19) Update: FDA Authorizes New Monoclonal Antibody for
Treatment of COVID-19 that Retains Activity Against Omicron Variant. Retrieved from FDA:
https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-
authorizes-new-monoclonal-antibody-treatment-covid-19-retains

Hetzler, L. (2020, July 10). Nursing Management for Patients with COVID-19. Retrieved from everynurse:
https://everynurse.org/nursing-management-covid-19/

World Health Organization. (2022, September 15). Clinical management of COVID-19. Retrieved from
World Health Organization: https://www.who.int/teams/health-care-readiness/covid-19