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NUR-635 Topic 13 DQ 2 • Online Nursing Essays

Sample Answer for NUR-635 Topic 13 DQ 2 Included After Question

Mary is a 37-year-old female who suddenly presents with onset of fever, chills, fatigue, body aches, dry cough, sore throat, and headache. After performing the necessary diagnostics, the FNP confirms Mary has influenza. Mary avoids getting a flu shot as she has an egg allergy. Use the guidelines and relevant literature in your topic Resources to discuss the following: 

Due to similar presentations, how would a clinician decipher if the patient has the flu or COVID-19? 

Determine a treatment strategy for Mary. Include the drug, dose, frequency, and treatment length, and explain your rationale for choosing this medication, including spectrum of coverage and mechanism of action.  
Determine monitoring, side effects, and drug-drug interactions associated with each medication. 
In the event Mary experienced these symptoms for 48 hours prior to coming to the clinic, how would this change your treatment strategy. Explain your rationale. 
Are there any flu vaccine options for Mary even though she has an egg allergy? 
In general, are there any racial or ethnic disparities in influenza-associated hospitalizations? 

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education 

This assignment aligns to AACN Core Competencies 1.2, 2.2, 2.5. 4.2, 6.4, 9.2 

A Sample Answer For the Assignment: NUR-635 Topic 13 DQ 2

Title: NUR-635 Topic 13 DQ 2

Differentiating Between Flu and COVID-19: 

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Differentiating between influenza (flu) and COVID-19 can be challenging due to their overlapping symptoms. Both illnesses can be present with fever, chills, fatigue, body aches, dry cough, sore throat, and headache. However, certain features can help distinguish them. COVID-19 often involves a sudden loss of taste or smell, shortness of breath, and gastrointestinal symptoms, which are less common in influenza. Diagnostic testing, including PCR or rapid antigen tests, is crucial for accurate identification (Lee et al., 2020). 

  

Treatment Strategy for Influenza (Flu): 

For Mary, considering her flu diagnosis, the preferred antiviral medication is oseltamivir (Tamiflu). The recommended dose is 75 mg orally twice daily for five days. Oseltamivir is a neuraminidase inhibitor, disrupting the release of virus particles from infected cells and inhibiting the spread of influenza within the respiratory tract (Rosenthal & Burchum, 2020). 

  

Monitoring, Side Effects, and Drug Interactions: 

Monitoring: Mary’s symptoms, especially fever and respiratory distress, should be closely monitored during treatment. 

Side Effects: Common side effects of oseltamivir include nausea and vomiting. Monitoring gastrointestinal symptoms is essential. 

Drug Interactions: Oseltamivir has minimal drug interactions. However, caution is advised when co-administered with probenecid, which may increase oseltamivir levels (Rosenthal & Burchum, 2020). 

  

Delayed Presentation (>48 hours): 

If Mary presents more than 48 hours after symptom onset, oseltamivir can still be beneficial, although its effectiveness decreases with delayed initiation. The treatment rationale remains, aiming to reduce symptom duration and severity. 

  

Flu Vaccine Options for Egg Allergy: 

Individuals with egg allergies can still receive influenza vaccines. The CDC recommends two options: a) a standard-dose influenza vaccine that is egg-based, with appropriate precautions, or b) a recombinant influenza vaccine (Flublok) that is not produced in eggs. 

  

Racial or Ethnic Disparities in Influenza Hospitalizations: 

Racial and ethnic disparities exist in influenza-associated hospitalizations. Studies within the past five years indicate that Black and Hispanic populations experience higher rates of hospitalization compared to White individuals. Socioeconomic factors, access to healthcare, and underlying health disparities contribute to these differences (Alexander et al., 2020). 

References: 

Alexandre, M. M. M., Adamian, C. M. C., de Menezes Galvão, L., Lopes, I. M. P., de Carvalho Gomes, P. E. A., de Almeida, C. A., … & de Francesco Daher, E. (2022). Current status of influenza: What do we know so far? Research, Society and Development, 11(13), e517111335808-e517111335808. 

  

Centers for Disease Control and Prevention: Sexually Transmitted Infections Treatment Guidelines, 2021: Gonococcal Infections Among Adolescents and Adults. 

  

Lee, K., Jalal, H., Raviotta, J. M., Krauland, M. G., Zimmerman, R. K., Burke, D. S., & Roberts, M. S. (2022, January). Estimating the impact of low influenza activity in 2020 on population immunity and future influenza seasons in the United States. In Open Forum Infectious Diseases (Vol. 9, No. 1, p. ofab607). US: Oxford University Press. 

  

Rosenthal, L. D., & Burchum, J. R. (2020). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants – e-book (2nd ed.). Elsevier Health Sciences. 

REPLY 

Chesany Yasuda 

replied toMarco Hernandez 

Nov 29, 2023, 11:58 AM 

Unread 

Hi Marco,  

You mentioned that oseltamivir can still have benefits when prescribed past the 48-hour mark, and I wanted to expand on that statement.  Some research indicates that the medication can be useful in vulnerable populations even when given outside this window.  A study by Fry et al. (2014) showed that starting oseltamivir after the 48-hour mark still had a modest benefit in children compared to the placebo group.  The median duration of symptoms was reduced by one day (Fry et al., 2014).  Similarly, patients hospitalized with prolonged influenza viral shedding may benefit from oseltamivir past the 48-hour mark (Khoury et al., 2018).  However, with only a small benefit in limited populations, prescribing oseltamivir past the 48-hour mark should only be done when the benefit outweighs the risk.    

  

Fry, A. M., Goswami, D., Nahar, K., Sharmin, A. T., Rahman, M., Gubareva, L., Azim, T., Bresee, J., Luby, S. P., & Brooks, W. A. (2014). Efficacy of oseltamivir treatment started within 5 days of symptom onset to reduce influenza illness duration and virus shedding in an urban setting in Bangladesh: a randomised placebo-controlled trial. The Lancet. Infectious diseases, 14(2), 109–118. https://doi.org/10.1016/S1473-3099(13)70267-6 

  

Khoury, J., Szwarcwort, M., Kra-oz, Z., Saffuri, M., Seh, K., Yahalomi, T., Braun, E., Azzam, Z. S., Paul, M., & Neuberger, A. (2018). Duration of viral shedding and factors associated with prolonged shedding among inpatients with influenza treated with oseltamivir: a prospective cohort study. European Journal of Clinical Microbiology & Infectious Diseases, 37(2), 319-323. https://doi.org/10.1007/s10096-017-3135-0 

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