2. INTRODUCTION
Coronaviruses are important human and animal
pathogens. At the end of 2019, a novel
coronavirus was identified as the cause of a
cluster of pneumonia cases in Wuhan, a city in
the Hubei Province of China. It rapidly
spread, resulting in an epidemic throughout
China, followed by a global pandemic.
3. CORONAVIRUS
• Coronaviruses are a large family of viruses that are
actually common throughout the world and can cause
respiratory illness in people and animals. There are
several known coronaviruses that infect people and
usually only cause mild respiratory disease, such as the
common cold. However, at least two previously identified
coronaviruses have caused severe illness — Severe Acute
Respiratory Syndrome (SARS) coronavirus and Middle
East Respiratory Syndrome (MERS) coronavirus
4. INCIDENCE
An outbreak of pneumonia of unknown etiology
in Wuhan City was initially reported to WHO
on December 31, 2019.
The world wide;
CoronavirusCases:61,308,613,Deaths:1,437,84
0 and Recovered:42,396,651
6. Coronaviruses are named for the crown-like spikes on
their surface.
There are four main sub-groupings of coronaviruses,
known as alpha, beta, gamma, and delta.
Human coronaviruses were first identified in the mid-
1960s.
The seven coronaviruses that can infect people are
229E (alpha coronavirus), NL63 (alpha coronavirus,
OC43 (beta coronavirus), and HKU1 (beta coronavirus).
Other human coronaviruses are MERS-CoV, SARS-
CoV, and COVID-19.
8. • COVID-19 is a betacoronavirus, like MERS
and SARS, all of which have their origins in
bats.
• The sequences from US patients are similar
to the one that China initially posted,
suggesting a likely single, recent emergence
of this virus from an animal reservoir.
9. • When person-to-person spread has occurred
with MERS and SARS, it is thought to have
happened mainly via respiratory droplets
produced when an infected person sneezes,
similar to how influenza and other respiratory
pathogens spread.
10. • Most coronaviruses infect animals, but not
people; in the future, one or more of these
other coronaviruses could potentially evolve
and spread to humans, as has happened in the
past.
• Many of the patients have direct or indirect
contact with the Wuhan Huanan Seafood
Wholesale Market that is believed to be the
original place of the outbreak of COVID-19.
11. • However, the transmission of COVID-19 from
fish to humans is unlikely.
• The COVID-19 and fish coronaviruses such as
Beluga Whale CoV/SW1 belong to different
genera and apparently have different host
ranges.
• As the Wuhan market seafood market also
sells other animals, the natural host of
COVID-19 awaits to be identified.
12. • Due to the possibility of transmission from animal
to human, CoVs in livestock and other animals
including bats and wild animals sold on the market
should be constantly monitored.
• In addition, more and more evidence indicates the
new virus COVID-19 is spread via the route of
human-to-human transmission because there are
infections of people who did not visit Wuhan but
had close contact with family members who had
visited Wuhan and got infected
14. Fever
Dry cough
Shortness of breath
Other symptoms may include:
Sore throat
Runny nose
Diarrhea
Fatigue/tiredness
Difficulty of breathing (in severe cases)
16. • At this time, diagnostic testing for
COVID-19 can be conducted only at
CDC
• To increase the likelihood of detecting
infection, CDC recommends collection
of three specimen types: lower
respiratory, upper respiratory, and
serum specimens for testing.
17. • CDC has deployed multidisciplinary teams to
Washington, Illinois, California, and Arizona to
assist health departments with clinical
management, contact tracing, and
communications.
• CDC has developed a real-time Reverse
Transcription-Polymerase Chain Reaction (rRT-
PCR) test that can diagnose COVID-19 in
respiratory serum samples from clinical
specimens.
18. • Currently, testing for this virus must take place at
CDC, but in the coming days and weeks, CDC will
share these tests with domestic and international
partners.
• CDC uploaded the entire genome of the virus from all
five reported cases in the United States to GenBank.
• CDC is also growing the virus in cell culture, which is
necessary for further studies, including for additional
genetic characterization
21. PHARMACOLOGICAL
MANAGEMENT• There is no specific antiviral
medication yet is recommended for
COVID-19 infection, and no current
vaccine to prevent it
22. NON PHARMACOLOGICAL
MANAGEMENT• Hand hygiene. Wash hands often with soap and
water for at least 20 seconds; if water and
soap are not available, use an alcohol-based
hand sanitizer.
• Keep hands off your face. Avoid touching the
eyes, nose, and mouth with unwashed hands.
• Maintain social distancing. Avoid close contact
with people at least 3 feet (1 meter) who are
sick, and stay at home when you are sick.
23. • Proper cough and sneeze etiquette. Cover your
cough or sneeze with a tissue, then throw the
tissue in the trash.
• Supportive care. People infected with COVID-
19 should receive supportive care to help
relieve symptoms.
• Severe cases. For severe cases, treatment
should include care to support vital organ
functions.
25. Nursing Assessment
Assessment of a patient suspected of COVID-19 should
include:
• Travel history. Health care providers should obtain a
detailed travel history for patients being evaluated
with fever and acute respiratory illness.
• Physical examination. Patients who have fever, cough,
and shortness of breath and who has traveled to
Wuhan, China recently must be placed under isolation
immediately.
26. Nursing Diagnosis
• Based on the assessment data, the major nursing
diagnosis for a patient with COVID-19 are:
1. Infection related to failure to avoid pathogen secondary
to exposure to COVID-19.
2. Deficient knowledge related to unfamiliarity with
disease transmission information.
3. Hyperthermia related to increase in metabolic rate.
4. Impaired breathing pattern related to shortness of
breath.
5. Anxiety related to unknown etiology of the disease
27. Nursing Care Planning and
Goals• Prevent the spread of infection.
• Learn more about the disease and its
management.
• Improve body temperature levels.
• Restore breathing pattern back to
normal.
• Reduce anxiet
28. Nursing Interventions
• Monitor vital signs. Monitor the patient’s temperature; the
infection usually begins with a high temperature; monitor the
respiratory rate of the patient as shortness of breath is
another common symptom.
• Monitor O2 saturation. Monitor the patient’s O2 saturation
because respiratory compromise results in hypoxia.
• Maintain respiratory isolation. Keep tissues at the patient’s
bedside; dispose secretions properly; intsruct the patient to
cover mouth when coughing or sneezing; use masks, and
advise those entering the room to wear masks as well; place
respiratory stickers on chart, linens, and so on.
29. • Enforce strict hand hygiene. Teach the patient
and folks to wash hands after coughing to reduce
or prevent the transmission of the virus.
• Manage hyperthermia. Use appropriate therapy for
elevated temperature to maintain normothermia
and reduce metabolic needs.
• Educate the patient and folks. Provide information
on disease transmission, diagnostic testing, disease
process, complications, and protection from the
virus
30. Evaluation
• Nursing goals are met as evidenced by:
Patient was able to prevent the spread of
infection.
Patient was able to learn more about the disease
and its management.
Patient was able to improve body temperature
levels.
Patient was able to restore breathing pattern back
to normal.
31. Documentation Guidelines
• Documentation guidelines for a patient with COVID-19 include the
following:
• Individual findings, including factors affecting, interactions, nature
of social exchanges, specifics of individual behavior.
• Cultural and religious beliefs, and expectations.
• Plan of care.
• Teaching plan.
• Responses to interventions, teaching, and actions performed.
• Attainment or progress toward the desired outcome
32. CONCLUSION
COVID-19 is an international pandemic with many implications
for nursing care in the emergency department. The first
priority of any nurse should be to protect themselves with the
appropriate PPE. The research on COVID-19 is preliminary and
speculative, including most treatments. Health care resources
may be overwhelmed at times, which may require alterations in
previous policies and protocols. Many patients with COVID-19
will be asymptomatic or minimally symptomatic and can isolate
and care for themselves at home. The elderly and those with
other medical conditions are most at risk for severe illness and
respiratory distress.
