PATHOPHYSIOLOGY AND CONCEPT MAP

Severe Acute Respiratory Distress Syndrome, High Risk, Severe acute Respiratory Infection.
Viral Pneumonia Related To Coronavirus Disease 2019 Infection

Predisposing Factor Precipitating Factors

 Travellers that travels
 Age: >60 years old, (WHO) to places with COVID
<14 years old (pediatric CC)
Infected person cough, sneeze or 19
 Patient with the following
talk without social distancing  Direct or Indirect
disease condition: (DM, HIV,
Cardiovascular diseases,
contact with the
cancer ) infected person
 Extreme obesity  Immunocompromised
 Taking Immunosuppresant  Smoking
drugs
 Undergoing chemotherapy Droplets with virus will spread to
another person

Inhalation of virus from the People touches contaminated

infected person objects
 LEGEND
Virus will enters to URT and LRT Direct contact with the virus
Prediposing Factors
Precipitating Factors
Nursing Diagnosis
Signs and symptoms
Medical/nursing management
Accidentally touches the mouth,
Disease process eyes, and nose

Virus will enter to mucous

membranes

From mucous membranes to

Respiratory tract

Virus rapidly replicate to the lungs

 Invasion of virus in the lungs Sensory detects Foreign substance
in the lungs (Virus)

High fever-38.8C
Hot flushed skin Immune response triggered Stimulation of cough in attempts
RR-56cpm suddenly, instead of gradually to remove the foreign substance
PR-120bpm
Irritable

Hyperactive Immune Response No-productive cough Ineefective airway

Altered body Excessive coughing clearance related to
temperature related o ineffective cough
viral infection

Oxygen supplementation
Unexpected Excessive release of
MDI-Albuterol 2 puff
Loosen clothing inflammatory Cytokines
Elavate HOB
Analgesics
Tepid sponge bath
Monitor I and O

Influx of inflammatory cells

(Neutrophils, Macrophages, platelets)
 Neutrophil aggregation and
release of mediators
(ROS, Proteolysic Enzyme, PAF,
Compliment activation

Damage to lung tissues

Progressive Fibrosis Increase Capillary Injury to bronchial Mucuosa

and Scarring permeability

Progressive Fibrosis
and Scarring
Causing fluid to
leak in and out of
the lungs Damage to goblet Cells Destruction of the cells Irritation of Vagus Nerve

Progressive Fibrosis
and Scarring

Decrease mucous Accumulation of cell debris Cough Reflex/Stimulation

Production in the lungs
 Accumulation of cell debris
in the lungs

Allowing virus to enter in Accumulation of fluid in the

different parts of the body alveoli and alveolar space
Elevated WBC-
20,000mEq/dL Alveolar inflammation
High grade fever
Pain and discomfort
Cold clammy skin
Systemic Viral replication Alveolar Edema Impaired gas exchange
related to ineffective
lung function secondary
Analgesic to alveolar edema
Tepid sponge bath
Extreme shortness of
Crystalloids fluid
breath that worsens
Vassopresor
Septic Shock when lying down Oxygen supplementation
steroids
Feeling of drowning MDI-Albuterol 2 puff
Cold clammy skin Elavate HOB
Restless
Risk for deficient fluid volume related O2sat- 88%
increase capillary permeability

Consolidation Impaired Oxygen Circulation

 Impaired gas exchange
related to ineffective
z lung function secondary ABG result: Impaired Oxygen Circulation
Pneumonia pH-7.0mmHg
to alveolar edema
PCO2-50mmHg

Oxygen supplementation O2sat- 88%

MDI-Albuterol 2 puff
Elavate HOB
Decrease oxygen in the
body
And increase Carbon Dioxide

Ineffective tissue
perfusion related to
decrease oxygen in the Decrease in tissue Perfusion PCO2 retention
body secondary to
decrease lung expansion

Oxygen supplementation Cyanosis

MDI-Albuterol 2 puff Pallor
Body response to abnormal
Elavate HOB Delayed capillary refill
activity
4 seconds
Generalized weakness
Body malaise

Stimulation of SNS to alter

functions of the lungs and
heart in attempts to
compensate abnormalities
 Shortness of breath
Shallow breathing
Irritable Increase in RR as the body An increase HR as the body
Palpatation
RR-56cpm attempts to get rid-off attempts to deliver enough
PR- 120 bpm
Use of retained carbon dioxide oxygen all throughout the
Restless
sternocledomastiod And get more oxygen for body
muscle when inhaling the body needs

Increase cardiac output

related to Compensatory Increase cardiac workload
Ineffective breathing mechanism
pattern related to
compensatory mech. Tachypnea

Oxygen supplementation
ECG
Oxygen supplementation
Anti-arrythmic agent Tachycardia
MDI-Albuterol 2 puff
Elavate HOB

Recovery Acute Respiratory Distress Death

syndrome