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).