Corona Virus (covid 19) slideshare

Covid 19 slideshare

1. wf Alysha Budhathoki BNS 2 nd year, 1 st Batch

2. Content Introduction Epidemiology Risk factors Pathophysiology Symptoms Incubation period Transmission Diagnosis

3. Treatment and prophylaxis Prevention and control Nursing intervention Care of ventilated patient Refrences

4. Introduction Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus . Corona virus are the group of virus that causes respiratory infections that are usally mild , including some cases of common cold. It was first identified in December 2019 in Wuhan, China.

5. This group of virus is named for club shaped protein spikes that protude from a viral surface and create an apperence corona(crown) when viewed via microscope.

6. Epidemiology In the past week, over 3.3 million new cases have been reported globally. As of 1 November, nearly 46 million cases and 1.2 million deaths have been reported globally. In Nepal, from Jan 3 to 4 November 2020, there have been 179,614 confirmed cases of COVID-19 with 1,004 deaths.

7. Epidemiological status acccording to WHO Reporting Country/Territory/Area- Nepal New cases in last 7 days- 15,510 Cumulative cases- 1,70,743 Cumulative cases per 1 million population - 5,860 New deaths in last 7 days- 95 Cumulative deaths- 937 Cumulative deaths per 1 million population- 32

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9. Risk Factors Conditions in which there’s strong evidence of increased risk include: Chronic kidney disease COPD,emphysema People with lower immune health because of a solid organ transplant Obesity-- those with a BMI greater than 30 Serious heart conditions like heart failure and coronary artery disease Sickle cell disease Type 2 diabetes

10. Hypertension Pregnency Smoking Asthma

11. Pathophysiology Spike surface glycoprotein of the virus binds to the host via receptor binding domains of the angiotensin converting enzyme 2 (ACE2), which is most abundant in type II alveolar cells 10 - 20 times higher binding affinity as compared with the SARS-CoV-1 virus After a SARS-CoV-2 attaches to a target cell, the virion releases RNA into the cell, initiating replication of the virus which further disseminates to infect more cells

12. Pathophysiology cont… Covid 19 produces several virulence factors that promote shedding of new virions from host cells and inhibit immune response Virus independent immunopathology in fatal COVID-19 Organ injury and death in COVID-19 is immune mediated rather than pathogen mediated

13. Symptoms Symptoms usually begin 2 to 14 days after you come into contact with the virus. Common symptoms Fever Fatigue Dry cough Loss of appetite Body aches Shortness of breath

14. Other symptoms Sore throat Headache Chills Loss of test and smell Runny nose Nausea , vomiting Diarrhoea

15. Sever symptoms Constant pain or pressure in your chest Bluish lips or face Sudden confusion Trobled breathing Organ failure Coma Decreased wbc

16. Incubation period On average, symptoms showed up in the newly infected person about 5 days after contact. Rarely, symptoms appeared as soon as 2 days after exposure. Most people with symptoms had them by day 12. And most of the other ill people were sick by day 14. In rare cases, symptoms can show up after 14 days. Researchers think this happens with about 1 out of every 100 people.

17. Some people may have the coronavirus and never show symptoms. Others may not know that they have it because their symptoms are very mild. Current studies might not include the mildest cases, and the Incubation period could be different for these. People who get infected with can spread it to others 2 to 3 days before symptoms start and are most contagious 1 to 2 days before they feel sick.

18. How Long Should I Quarantine After I’ve Been Exposed to the Coronavirus ? If you might have come into contact with the virus and have no symptoms, you should self-monitor.(watching for signs such as fever, cough, and shortness of breath) Stay out of crowded places, keep at least 6 feet away from other people, and wear a cloth face maskwhen you have to go out.

19. If you traveled recently or know that you came into contact with someone who has COVID-19, you should self-quarantine. Stay home for 14 days. It’s very rare for symptoms to show up after that much time. Check your temperature twice a day, and watch for other symptoms. Stay away from other people, especially those who are at high risk of serious illness because of their age or another medical condition.

20. Transmission Person to person transmission Droplets or aerosols: When an infected person coughs, sneezes, or talks, droplets or tiny particles called aerosols carry the virus into the air from their nose or mouth. Anyone who is within 6 feet of that person can breathe it into their lungs.

21. Fecal-oral: Studies also suggest that virus particles can be found in infected people's poop. But experts aren't sure whether the infection can spread through contact with an infected person's stool. If that person uses the bathroom and doesn't wash their hands, they could infect things and people that they touch.

22. Airborne transmission. Research shows that the virus can live in the air for up to 3 hours. It can get into your lungs if someone who has it breathes out and you breathe that air in. Surface transmission: Another way to catch the new coronavirus is when you touch surfaces that someone who has the virus has coughed or sneezed on.

23. Cont… You may touch a countertop or doorknob that's contaminated and then touch your nose, mouth or eyes. The virus can live on surfaces like plastic and stainless steel for 2 to 3 days. To stop it, clean and disinfect all counters, knobs, and other surfaces you and your family touch several times a day.

24. Diagnosis PCR test – oropharyngeal , nasopharyngeal swab Blood test - virus culture antibody detection ABG,CBC Chest x-ray HRCT

25. Treatment There is no vaccines . Work is underway to develop one , but a vaccine is unlikely to be developed before 2021. There is no antiviral treatment specifically for COVID-19. Symptoms are managed using standard methods of care for viral infections. Antibiotics , which only treat bacterial infections are not useful to treat COVID-19 or other viral disease. Treatments depends on stage of illness.

26. Prophylaxis Antiviral drugs( Hydroxychloroquine , Chloroquine ): Both chloroquine and hydroxychloroquine have in vitro activity against SARS- CoV and SARS-CoV-2. 5,6 A small cohort study without a control group has suggested that hydroxychloroquine might reduce the risk of SARS-CoV-2 transmission to close contacts. 7

27. Cont.. Antibiotics: . Azithromycin are quite effective in preventing pulmonary infections in patients with viral pneumonias, in addition to having a significant anti-inflammatory effect on the airways. vitamin supplements: vitamin B complex, vitamin D, vitamin C, zinc

28. Cont… Corticosteroids Steroids can be used for a short period of time, that is, 3–5 days in patients who show progressive deterioration of oxygen saturation, increased activation of the pro-inflammatory response and rapid worsening of features on chest imaging. Dexamethasone has also been found to be effective for decreasing mortality in severe and critically ill cases.

29. Cont.. Plasma therapy: Blood is taken from a previously infected but completely recovered patient, the plasma component of that blood is separated and that contains the antibodies against SARS-CoV-2 virus. This plasma is injected into an infected person’s body that will fight the virus and neutralise it from spreading.

30. Prevention and control There are a number of ways to prevent the spread of COVID-19 infection. These include: Avoid touching your eyes, nose and mouth Avoid close contact with people who are sick Remember that some people without symptoms can still spread the virus Stay at home when you are sick Cover your cough or sneeze with a tissue, then dispose of it properly

31. Use a face covering when physical distancing is difficult or when going into closed spaces 8 Physical distancing should be at least 1 meter (3 ft) Clean and disinfect frequently touched objects and surfaces Perform hand hygiene with soap and water or use alcohol-based hand rub Hand Rub should contain at least 60% alcohol 9 Hand washing should be done for at least 40-60 seconds based on WHO’s recommendations

32. IPC Priorities Rapid identification of suspect cases Screening/Triage at initial healthcare facility encounter and rapid implementation of source control Limiting the entry of healthcare workers and/or visitors with suspected or confirmed COVID-19 Immediate isolation and referral for testing Group patients with suspected or confirmed COVID-19 separately Test all suspected patients for COVID-19

33. Safe clinical management Immediate identification of inpatients and healthcare workers with suspected COVID-19 Adherence to IPC practices Appropriate use of Personal protective equipment (PPE) PPE are recommended for healthcare workers before entering the room of suspected or confirmed COVID-19 patients https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf

34. Nursing Intervention Nursing assessment : History Taking Physical examination Nursing diagnosis : Impaired breathing pattern related to shortness of breath Anxiety associated with the unknown etiology of the disease Deficient knowledge related to unfamiliarity with disease transmission information

35. Planning : Assessing altered skin integrity risks, fatigue, impaired comfort, gas exchange, nutritional needs, and nausea. Preventing the spread of coronavirus infection to the patient’s family members, community, and healthcare providers. Reducing fever and Restoring normal respiratory patterns. Reducing anxiety.

36. Nursing interventions: Monitor vital signs – temperature and respiratory rate, Monitor O2 saturation Manage fever Maintain respiratory isolation Enforce strict hand hygiene provide information related to disease condition

37. Evaluation The patient successfully prevented the spread of infection to family, the community, or to healthcare staff. The patient learned more about COVID-19 and its management. The patient had improved body temperature levels. Restoration to normal breathing patterns. Reduced anxiety.

38. Care of ventilated patient Covid 19 can cause verious complications like ARDS, Pneumonia , organ failure etc. this can lead to use of mechanical ventilation to the patient. For the care of ventilated patient , we should have enough knowledge regarding the mechanical ventilation Nursing care related to ventilated patient are:

39. Maintain ventilator settings Maintain sealed system between ventilator and client so that volume to be delivered is kept constant and air is not lost around tubing accomplished by inflating the cuff of ET tube. Prevent high pressure alarm Perform suction as needed, use bite block if the patient is biting ET tube Consult with the health care provider about need for sedative or neuromuscular blocking agent if patient seems to fight ventilator.

40. Ascess for signs of respiratory insufficency ie adventitious breath sound , hypoventilation , cynosis Maintain PEEP to alveoli open , increasing functional residual capacity . Check pulse oximeter and blood gases to determine effectiveness of ventilation. Establish means of communication because patient will be unable to speak while in ventilator. Provide oral care and suction oral cavity as needed. Pariticipate with respiratory therapist to gradually increase spontaneous breathing trials to wean hemodynamically stable client from ventilator.

41. https://www.verywellhealth.com/covid-19-pre-existing-conditions-4801962 https://www.webmd.com/lung/news/20200625/cdc-updates-covid-19-risk-factors Https://www.webmd.com/lung/covid-19-symptoms#1 https://pmj.bmj.com/content/early/2020/10/06/postgradmedj-2020-138577 https://everynurse.org/blog/nursing-management-covid-19/

42. http://www.pathologyoutlines.com/topic/lungnontumorcovid.html https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-020-00689-1#Fig1 https://www.ecri.org/covid-19-clinical-guidelines-critical-care