Case of Bird Flu

A 37-year-old woman came to the hospital accompanied by complaints of high fever 10 days
ago, the patient also felt satisfied, pain in the throat, dry cough, headaches, weakness, stomach
and joints, colds and diarrhea. The nurse did a check on the patient's body temperature with
complaints of high fever since 10 days ago, the Nurse conducted an examination obtained by
patients with a body temperature of 39 ° C and the patient seemed to have no strength and
anxiety. Based on the results of the anamnase, the patient is a poultry breeder (chicken), which
every morning is always in contact with poultry, with the position of the chicken behind the
patient's home, only 5 meters away and open.

symptom etiology problem

1. Viral infection 2. Late and
Subjective data improper handling 3. Every 1. Viral infection

1. The patient said high fever morning contact with poultry 2. Airway obstruction
(chickens) and the cage
since 10 days ago. 3. Late and improper handling.
position is rarely cleaned and

2. Tegorokan pain close to the patient's home.

3. Dry cough

4. Headaches

5. Limp

6. No appetite

7. Abdominal pain

8. Joint pain

9. diarrhea

DO :

1. S = 39 ° C
2. TD = 120/80 mmHg

3. N = 100 / min

4. P = 30x / min

5. Vomiting

6. Conjunctitis (eye membrane

infection)

Supporting data:

The patient said that his work

was a poultry (chicken)

breeder, who was always in

contact with poultry every

morning and the chicken coop

position was behind the

patient's home, only 5 meters

away and the cage was rarely

cleaned.
Nursing diagnoses :

1. Ineffectiveness of the airway clearance bd obstruction of the airway

2. Acute pain in biological causative agents

3. Nutrient imbalance is less than the body's need for no appetite, vomiting and diarrhea

Nursing diagnoses Goals & Criteria Results Intervention (NIC)

(NOC)

The ineffectiveness of the After nursing action, it is 1. Assess respiratory status for

airway clearance is related to expected that the problem of at least 4 hours

the obstruction of the airway ineffective airway clearance 2. Teach the patient an

can be resolved with the effective cough

expected outcomes: 3. Avoid supine positions for

1. The airway remains patent long periods. Give

2. The patient takes out encouragement to choose a

sputum sitting position and upright.

3. Patients cough effectively 4. Provide tissue and paper

4. The patient demonstrates a bags for hygienic sputum

controlled cough technique. disposal.

5. Perform chest

physiotherapy
 After nursing action, it is 1. Perform a comprehensive

Acute pain is associated with expected that the problem of pain assessment including

biological causative agents ineffective airway clearance pain location, characteristics,

can be resolved with the duration, frequency, quality,

expected outcomes: and intensity of pain.

1. The patient's pain can be Determine whether the pain

reduced the patient is suffering from is

2. The patient is able to acute pain or chronic pain.

control pain 2. Ask the patient to use a

3. Patients express feelings of switch 1 to 10 to find out the

comfort. level of pain (with a value of

4. The patient is able to handle 10 being the heaviest level of

pain pain)

3. Set the patient's rest period

without being interrupted.

4. Help the patient to get a

comfortable position

5. Teach pain control

techniques to provide the

recommended medicine

according to indications.
An imbalance of nutrients less After nursing action, it is 1. Weigh and record the

than the body's needs is expected that the problem of patient's weight at the same

related to no appetite, ineffective airway clearance time every day.

vomiting and diarrhea can be resolved with the 2. Monitor patient intake and

expected outcomes: output

1. Patients no longer show 3. Give the recommended

evidence of weight loss. food through the hose to

2. Patients tolerate food supply nutritional needs

through the tube 4. Check the location of the

3. Patients avoid vomiting food hose at least one change

4. Patients avoid diarrhea of duty duty and record the

5. The patient's body weight patient's bowel noise once

increases every change of duty

6. The patient and family 5. Auscultate and record the

members know the patient's breathing every 4

understanding of the diet hours. If aspiration is

given by the nurse suspected, stop giving food

6. Teach patients and family

members in the procedure of

feeding through the hose.

Watch as they demonstrate

again until competence is

achieved.