COVID-And-Tuberculosis PDF

CORONAVIRUSES How long does it take to get coronavirus test results? - You should receive your test results as...

CORONAVIRUSES How long does it take to get coronavirus test results? - You should receive your test results as early as 4 hours after sample collection. *4- are a large family of viruses ¾ days depending on the sample given in a novel coronavirus (nCoV) is a new strain that has the laboratory not been previously identified in humans. The new virus was subsequently named the "CÓVID-19 virus MEDICAL MANAGEMENT  animal-human transmission Antiviral Drug ✓ person to person direct contact ✓ about 3 feet Remdesivir. FDA approved to treat /COVID-19 in COVID-19 is a beta corona virus like MERS and - hospitalized adults and children who are a 12 and SARS, all of which have their origins in bats. older in the hospital. The seven coronaviruses thar can infect people are Baricitinib. for those who are on. mechanical 229E (alpha coronavirus), NL63 (alpha coronavirus, ventilators or need supplemental oxygen OC43 (beta coronavirus), and HKU1 (beta The combination of two antibodies called coronavirus). Other human coronaviruses are and casirivimab and imdevimab Other human coronaviruses are MERS and SARS It is used to treat mild to moderate COVID-19 in *2-14 days after exposure- INCUBATION PERIOD people who have a higher risk of developing-Serious illness due to COVID-19; MODE OF TRANSMISSION Who have recent been exposed the COVID-19 who direct, indirect, or close contact with infected people are at high risk of exposure. through infected secretions such as saliva and This treatment is for people who aren't fully respiratory secretions or their respiratory droplets, vaccinated, who are fully vaccinated but have a when an infected person coughs, sneezes, talks or weakened immune system. sings. NURSING MANAGEMENT SIGNS AND SYMPTOMS Nursing Assessment Fever or chills Travel history. obtain a detailed travel history for Cough patients being evaluated with fever and acute Shortness of breath or difficulty /breathing respiratory illness Fatigue Physical examination. Patients who have fever, Muscle or body aches cough, and shortness of breath and who has traveled Headache to Wuhan, China recently must be placed under New loss of taste or smell isolation immediately Sore throat Monitor vital signs. Monitor the patient's Congestion or runny nose temperature; and the respiratory rate of the patient Nausea or vomiting Monitor 02 saturation. Diarrhea Maintain respiratory isolation. Keep tissues at the patient's bed dispose secretions DIAGNOSTIC TEST property, instruct the patient to cover mouth when Swab- an accurate and reliable test for diagnosing COVID-19 coughing or sneezing; use masks, and advise those entering the room to Different types of nose swabs: wear masks as well; Nasal. It collects a sample immediately inside your place respiratory stickers on that, linens, and so o nostrils Enforce strict hand hygiene. Nasopharyngeal swab. It goes further into nasal Manage hyperthermia. cavity for collection Educate the patient folks. Provide information on It is a molecular test that looks for genetic material of disease transmission, diagnostic testing, disease RNA SARS-CoV-2, the virus that causes COVID-19 process, complications, and protection from the It has been the gold standard test, för diagnosing virus. COVID-19 since authorized for use in February 2020. PREVENTION MERS-CoV is a coronavirus that causes Middle East Respiratory Syndrome (MERS) Washing hands frequently with water and soap or → SARS-CoV-2, the novel coronavirus that using hand-sanitizing gel; appeared in 2019, causes an acute Maintaining social distancing (keeping a distance respiratory disease called coronavirus of between yourself and anyone who is coughing- disease 2019 (COVID-19 for short). Sneezing); → The disease is believed to have originated Avoiding touching eyes, nose, and mouth through animal-to-human transmission but WHAT IS THE CURRENT PANDEMIC? soon began to spread via human-to-human transmission. December 2019: a novel (new) coronavirus was → COVID-19 is related to the previously identified in Wuhan, China. known diseases SARS and MERS which This virus has since been named SARS CoV-2 for are caused by different, but related, viruses. severe acute respiratory syndrome coronavirus 2. It was previously called 2019 novel coronavirus HOW DOES THE VIRUS INVADE THE HOST? (2019-nCoV). Respiratory symptoms occur when the virus infects The disease caused by SARS-CoV-2 is called cells of the alveoli within the lungs. COVID-19 The virus accesses these host cells when a March 11, 2020: After the disease caused by this glycoprotein spike on the outside of the virus binds coronavirus spread to 114 countries, the World to a specific protein called ACE2 found on type II Health Organization declared it to be a pandemic alveolar cells likely to spread across the globe. CLINICAL MANIFESTATIONS CORONA VIRUS Fever or chills Are large family of viruses that causes illness ranging Fatigue from the common cold to more severe diseases. Respiratory symptoms A novel corona virus (n COV) is a new strain that has → dry cough not been previously identified in humans. The new → shortness of breath or DOB virus was subsequently named the COVID 19 virus. → can lead to pneumonia Causative agent: SARS COV2 Muscle or body aches Incubation period: between 2-14 days Headache Mode of transmission: direct, indirect or close New loss of smell and taste contact with infected people through secretions such Sore throat as saliva and respiratory secretions or their respiratory droplets which are expelled when an Congestion or runny nose infected person cough, sneezes, talks or sings Nausea This group of viruses is named for the club shaped Vomiting protein spikes (artificially colored red in the computer Diarrhea model) that protrude from the viral surface and Symptoms typically appear 2-14 days (average: 5-6 days) create the appearance of a “corona” (crown) when after exposure. However, many people may be infected but viewed via an electron microscope. show no symptoms CLASSIFICATION Common Uncommon Severe Symptoms a. Virus Symptoms Symptoms Fever Headache High fever b. realm Riboviria Dry cough Loss of taste/ smell Coughing up c. phylum incertae sedis Shortness of Nasal congestion blood d. order nidovirales breath Sore throat Decreased white e. family coronaviridae Fatigue Productive cough blood cells f. subfamily orthocoronavirinae (sputum) Organ failure Muscle/joint pain Coma Some coronaviruses cause serious diseases in humans: Chills Nausea SARS-CoV is a coronavirus that causes severe Vomiting acute respiratory syndrome (SARS), recognized in Diarrhea 2002 MEDICAL MANAGEMENT TUBERCOLOSIS 1. Antiviral drug REMDESIVIR (Veklury) - FDA approved to treat COVID 19 in hospitalized adults Tuberculosis and children who are age 12 and older in the hospital known pathognomonic signs: (Hall mark specific unique) 2. BARICITINIB - emergency use authorization for the rheumatoid arthritis drug reducing inflammation and 1. Hemoptysis – blood strict sputum, rusty sputum having antiviral activity who are on mechanical (pneumonia) ventilators or need supplemental oxygenation 2. Fever low grade – in the afternoon 3. Combination of 2 antibodies: CASIRIVIMAB and 3. Night Sweats IMDEVIMAB—used to treat mild to moderate COVID 4. Weight Loss – Rifampicin 19 people who have a higher risk of developing R – Red/orange Urine (rifampicin) serious illness due to COVID 4. INTERFERON - antiviral drug I – Isoniazid (numbness) 5. HEMOPERFUSION P – Pyrazinamide (kidney & liver) 6. ANTI - COAGULATION may help at certain stage E – Ethambutol (eyes) SUPPORTIVE CARE is aimed at relieving symptoms S – Streptomycin (sound) Pain relievers (ibuprofen or acetaminophen) 1. Red/orange urine- even sweats Cough syrup or medication (azithromicin, fluimucil) 2. Isoniazid- peripheral neuritis or numbness, or Rest tingling of extremities Fluid intake + has to take vitamin B6 (pyridoxine) Vit C, Zinc, Vit B Complex + eliminate or counter effects of numbness 3. Pyrazinamide- purine rich foods, common side WHO: PROTECT OURSELF AND OTHERS effect 1. Washing hands frequently with soap and water or + Hyperuricemia or gout use hand sanitizing gel - Avoid mongo, beans, legumes and organ meats 2. Maintaining social distancing Nephrotoxic 3. Avoiding touching eyes, nose and mouth 4. Wearing mask as needed Hepatotoxicity – if patient is taking liver enzyme 5. Following respiratory hygiene (covering your mouth ALT/SGPT – 4 – 36 u/L (normal) and nose with your folded elbow or tissue when you AST/SGOT – 8 – 33 u/L cough or sneeze) 4. Ethambutol 6. Seeking medical care early if you have fever, cough - Side effects and DOB + optic neuritis Inability 7. Availing vaccination + green – yellow discrimination need + snellen chart + because it may cause permanent loss of vision 5. Streptomycin - Damages 8th + Cranial nerve - Vestibulocochlear / auditory nerve – balance - Vertigo / tinnitus – ringing of bell An infectious disease primarily affecting the lung parenchyma, is most often caused by Mycobacterium tuberculosis Incubation Period: 2-10 weeks Mode of Transmission: → airborne droplet method through coughing, singing or sneezing; → bovine tuberculosis results from exposure to tuberculosis cattle RISK FACTORS Class Type Description No TB No history of exposure Close contact with someone who has active TB 0 exposure Not Negative reaction to Alcoholism infected tuberculin skin test Residence in overcrowded, substandard housing or TB exposure History of exposure Institutions (e.g., long-term carepatients, psychiatric 1 No evidence of Negative reaction to patients, prison inmates) infection tuberculin skin test Immunocompromise (e.g., elderly, cancer, Positive reaction to tuberculin corticosteroid therapy, and HIV) skin test Patients with preexisting medical conditions, TB infection Negative bacteriologic 2 including diabetes, chronic renal failure, and No disease studies (if done) malnourishment No clinical, bacteriologic, or Immigrants from countries with a high incidence of radiographic evidence of TB TB (egg, Haiti, southeast Asia) M. tuberculosis cultured (if People lacking adequate health care (e.g., homeless done) TB clinically 3 Clinical, bacteriologic, or or impoverished, minorities, children, and young active radiographic evidence of adults) current disease Occupation (e.g., health care workers, particularly History of episode(s) of TB or; those performing high - risk activities) Abnormal but stable radiographic findings Positive reaction to the TB Not 4 tuberculin skin test clinically active Negative bacteriologic studies (if done) and; No clinical or radiographic evidence of current disease Diagnosis pending 5 TB suspect TB disease should be ruled in or out within 3 months MANIFESTATIONS Fatigue, malaise Anorexia, weight loss Chronic cough-malproductive initially then mucopurulent- hemoptysis Low grade fever in the afternoon Night sweats Chest pain Diminished breath sounds- crackles, fremitus and egophony DIAGNOSTIC EXAMINATIONS Chest X-ray- reveal lesions on the upper lobe Tuberculin skin testing (Mantoux test) Sputum AFB- confirm presence of mycobacterium QuantiFERON TB Gold test → newest test for detection of TB → result with in or less than 24hours → result indicate that the patient is infected with TB DSSM (DIRECT SPUTUM SMEAR SMEAR MICROSCOPY COMPLICATIONS 14. Inform patient that rifampin may discolor tears and contact lenses. Eyeglasses may be substituted for Pleural effusion contact lenses. Pneumonia 15. Caution about the spread of TB infection from lungs MEDICAL MANAGEMENT to other body sites, a consequence of late reactivation of dormant infection. Isoniazid (INH) is given prophylactically in a single 16. Instruct that TB is no longer contagious 2-3 weeks daily dose for 6 to 12 months after starting chemotherapy or after 2 negative sputum culture. PHARMACOLOGIC THERAPY GOALS First-line medications a. Promote airway clearance INH, rifampin, ethambutol, and pyrazinamide daily b. Advocating adherence to treatment regimen for 8 weeks and continuing for up to 6 to 7 month c. Promoting activity and adequate nutrition Second-line medications d. Preventing spreading of tuberculosis infection Capreomycin, Ethionamide, Para-aminosalicylate Sodium, and Cycloserine TREATMENT: Anti-tuberculosis Drugs (RIPES) 1. Rifampicin - broad spectrum antibiotic 2. Isoniazid - interferes with metabolism of tubercle bacilli 3. Ethambutol - bacteriostatic for bacilli 4. Streptomycin – bactericidal 5. Pyrazinamide - bacteriostatic NURSING INTERVENTIONS 1. Patient should wear surgical mask when advised 2. Health care workers should wear particulate respirator/n-95 mask 3. Instruct about best position: to facilitate drainage 4. Encourage increased fluid intake. 5. Plan a progressive activity schedule with the patient to increase activity tolerance and muscle strength, 6. A nutritional regimen of small, frequent and nutritional supplements 7. Explain that TB is a communicable disease and that taking medications is the most effective way of preventing transmission. 8. Instruct about hygiene measures, including mouth care, covering mouth and nose when coughing and sneezing, proper disposal of tissues, and hand washing. 9. Assess for side effects of medication therapy and signs of multidrug resistance. 10. Encourage patient to obtain liver and kidney function follow-up studies 11. Monitor sputum culture results: to evaluate effectiveness of therapy. 12. Teach patient to take medications on empty stomach or 1 hour before meals: food interferes with drug absorption. 13. Teach patients taking INH to avoid foods containing tyramine and histamine (tuna fish, aged cheese, yeast extract).