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Influenza Nursing Guide

This clinical guide provides a quick reference for understanding influenza, emphasizing nursing considerations using the nursing process.

Content reviewed by Ann Dietrich, MD, FAAP, FACEP.

An Overview of Influenza

ICD-10 Code for Influenza: J10.1 

  • Influenza with other respiratory manifestations, seasonal influenza virus identified.

Influenza Etiology and Epidemiology 

Influenza is defined by the Centers for Disease Control and Prevention (CDC) as a contagious respiratory illness in humans caused by influenza viruses. These viruses can infect the nose, throat, and sometimes the lungs, causing mild to severe illness and occasionally death. According to a CDC study in 2018, approximately 8% of the U.S. population is infected with influenza each season (Olsen et al., 2018). Unlike the gradual onset of a common cold, influenza symptoms typically appear suddenly. 

High-Risk Groups: 

  • Children under 5 years old 
  • Pregnant women 
  • Adults 65 years and older 
  • Individuals with chronic health conditions such as asthma, diabetes, heart disease, and chronic obstructive pulmonary disease (COPD) 

Complications: 

  • Bacterial pneumonia 
  • Ear infections 
  • Sinus infections 
  • Worsening of chronic medical conditions 

Types of Influenza Viruses: 

  • Influenza A and B: Cause seasonal influenza epidemics almost every winter. 
  • Influenza C: Causes mild illness and does not lead to epidemics. 
  • Influenza D: Primarily affects cattle and does not infect humans. 

Transmission: The influenza virus spreads through tiny droplets produced when an infected person coughs, sneezes, or talks. These droplets can land in the mouths or noses of people nearby. Transmission can also occur by touching surfaces contaminated with the virus and then touching the mouth, nose, or eyes. 

Contagious Period: 

  • Most contagious in the first 3 to 4 days after symptoms begin. 
  • Contagious one day before symptoms develop. 
  • Contagious 5 to 7 days after developing symptoms. 
  • Young children and individuals with weakened immune systems may be contagious for longer. 

Influenza Diagnosis 

Diagnosis of influenza is based on a thorough physical exam and medical history. Symptoms often appear suddenly and can vary in severity, including: 

  • Fever 
  • Chills 
  • Cough 
  • Sore throat 
  • Runny or stuffy nose 
  • Muscle or body aches 
  • Headache 
  • Fatigue 
  • Vomiting or diarrhea (more common in children) 

Diagnostic Tests: 

  • Rapid Influenza Diagnostic Tests (RIDTs): Detect viral antigens within 10 to 15 minutes but are less accurate than other tests. 
  • Healthcare Provider Assessment: Diagnosis may be based on clinical presentation even if RIDT results are negative. 

Influenza Management 

Management of influenza depends on age, chronic health conditions, and the severity of the illness. Treatment includes: 

  • Antiviral Medications: 
    • Oseltamivir (Tamiflu®) 
    • Zanamivir (Relenza®) 
    • Peramivir (Rapivab®) 
    • Baloxavir marboxil (Xofluza®) 
  • Over-the-Counter Medications: 
    • Acetaminophen (Tylenol®) 
    • Ibuprofen (Motrin®, Advil®) 
  • Supportive Care: 
    • Bed rest 
    • Avoiding close contact with others 
    • Hand hygiene 
    • Fluid intake 
    • Annual influenza vaccination 

Influenza Nursing Care Plan 

Assessment 

  • Signs and symptoms: fever, cough, fatigue, chills, muscle or body aches, sore throat, runny nose 
  • Medical history of chronic conditions such as asthma or heart disease 
  • Allergies, especially to eggs 

Nursing Diagnoses/Risk For 

  • Ineffective Airway Clearance: Related to nasal secretions, evidenced by decreased breath sounds, runny nose, cough, sputum production. 
  • Ineffective Breathing Pattern: Related to viral infection, evidenced by coughing, tachypnea, fever, dyspnea, diaphoresis, fatigue. 
  • Acute Pain: Related to influenza, evidenced by verbalization of pain, body aches, cough. 
  • Activity Intolerance: Related to weakness, evidenced by verbalization, fatigue, shortness of breath. 

Interventions 

  • Administer oxygen as needed. 
  • Encourage fluid intake. 
  • Administer medications as ordered (antiviral, fever reducers, pain medications). 
  • Monitor vital signs. 
  • Perform chest percussion. 
  • Encourage repositioning and rest. 
  • Prevent cross-contamination. 
  • Provide education to the individual and family. 

Expected Outcomes 

  • Achieve and maintain a patent airway 
  • Achieve and maintain a normal breathing pattern 
  • Achieve and maintain a normal body temperature 
  • Decrease in pain 
  • Increase in activity tolerance 

Individual/Caregiver Education 

  • Educate on the condition, treatment, and expected outcomes. 
  • Influenza prevention: vaccination, hand hygiene, cough and sneeze etiquette. 
  • Adherence to the medication regimen. 
  • When to notify a healthcare provider: increased shortness of breath, fever, worsening of chronic health conditions. 

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Additional Information

Content Release Date 

3/31/2022

Content Expiration

12/31/2024

References

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