CORONAVIRUS

DISEASE
(CoVid-19)
Prepared by: De Luna, Jim Boy
Delos Santos, Daniella Kate
Ellerma, Vincent Maui M.
 BACKGROUND
•In December 2019, there was a cluster of pneumonia cases in
the city of Wuhan in China. Some of the early cases had
reported visiting or working in a seafood and live animal
market in Wuhan

•Investigations found that disease was caused by a newly

discovered coronavirus. The disease was subsequently named
covid 19. Covid 19 spread within china and to the rest of the
world

•On January 30 2020, WHO declared the outbreak , a public

health emergency of international concern
 BACKGROUND
➡ ➡
️ ️

➡️
➡️ ➡️
 BACKGROUND

Co -Corona
Vi -Virus

D -Disease
19 -Year when it was discovered (2019)
 CHAPTER I

INTRODUCTION
 CORONAVIRUS DISEASE / COVID-19?

•Are large group of viruses , they

consists of a core of genetic material
surrounded by a lipid envelope with
protein spikes . This gives it the
appearance of a crown, crown in Latin
is called corona and that's how these
viruses get their name
THE VIRUS
CORONAVIRUS DISEASE / COVID-19?
•Coronavirus disease (COVID-19) is an
infectious disease caused by the SARS-
CoV-2 virus.

CoVid 19 = Disease
SARS Cov 2 = Virus
COVID-19 has been found to be
the cause of severe pneumonia and
acute respiratory distress syndrome
(ARDS) with a significantly high
mortality rate.
HOW DOES COVID ATTACK YOUR BODY?

•A virus infects your body by entering healthy cells. There,

the invader makes copies of itself and multiplies
throughout your body.
The new coronavirus latches its spiky surface proteins to
receptors on healthy cells, especially those in your lungs.
 PHYSICAL ASSESSMENT
Body Parts Normal findings Actual findings Result

 Skin is the same in color  Patient may appear

SKIN as in the complexion. dehydrated Abnormal
•No lesions noted on (decreased skin

turgor and dry
inspection.
mucosa) due to
increased
respiratory rate,
nausea and
vomiting,

 Skin discoloration
and rashes

 Cyanosis depicts
severe hypoxemia
and the need for
supplemental
oxygen.
 PHYSICAL ASSESSMENT
Body Parts Normal findings Actual findings Result

 Nostrils are uniform in size  Runny nose and

NOSE and do not flare nasal congestion Abnormal
 No polyp or deviation are relatively
 No discharge or foreign common physical
bodies exam findiings
 PHYSICAL ASSESSMENT
Body Parts Normal findings Actual findings Result

 No difficulty in swallowing  Throat

NECK  No titling of head congestion, Tonsil Abnormal
 No masses, scars edema have been
(THROAT)
 Thyroid gland not visible reported
and enlarged
 No stiffness ,swelling , and
no tenderness along the
neck
 PHYSICAL ASSESSMENT
Body Parts Normal findings Actual findings Result

 Evenly place and inlined  Redness

EYES AND with each other Abnormal
 None protruding  Swelling
EYELIDS
 Upper eyelids cover the
small portion of the iris,
cornes and sclera when
eyes are open
 Meets completely when
eyes are closed
 Symmetrical
 PHYSICAL ASSESSMENT
Body Parts Normal findings Actual findings Result

 No involuntary movement  Pedal Edema is

LOWER  No edema noted Abnormal
 Color is even (rash/swelling)
EXTREMETI
 Temperature is warm and
ES even
 Has equal contraction and
even
 CHAPTER II
Discussion of the Case
 DISCUSSION OF THE CASE
Presentations of COVID-19 have ranged from
asymptomatic/mild symptoms to severe illness and
mortality. Common symptoms have included fever,
cough, and shortness of breath.

More Severe Diseases

•Middle East Respiratory Syndrome (MERS-CoV)

•Severe Acute Respiratory Syndrome (SARS-CoV)

 DISCUSSION OF THE CASE
COVID-19: vulnerable and high risk groups

•Older People

•People with other serious illness

•People who are Physically inactive

DISCUSSION OF THE CASE
COVID 19 DASHBOARD
ANATOMY AND PHYSIOLOGY

The respiratory system is the

network of organs and tissues
that help you breathe. It
includes your airways, lungs and
blood vessels. The muscles that
power your lungs are also part
of the respiratory system
 ANATOMY AND PHYSIOLOGY
Alveoli

The pulmonary alveolus is a sac roughly

0.2 to 0.5 mm in diameter. These alveoli
are located at the ends of air passageways
in the lungs. Sometimes, people compare
alveoli structures to the appearance of a
raspberry or a “bunch of grapes.”
 ANATOMY AND PHYSIOLOGY
• In the average adult lung, there is an Alveoli
average of 480 million alveoli (with a
range of 274-790 million, coefficient
of variation: 37%; although this
number varies depending on total lung
volume), with a total average surface
area of around 75 square meters. Each
alveolus is in turn surrounded by a
nest of blood capillaries supplied by
small branches of the pulmonary
artery.
 ANATOMY AND PHYSIOLOGY

Type 1 Type 2
Pneumocytes Pneumocytes
 ANATOMY AND PHYSIOLOGY
Alveolar Macrophages
• The most numerous of all cells
in the lung are the alveolar
macrophages (dust cells),
which drift through the alveolar
lumens and the connective
tissue between them clearing
up debris through phagocytosis.
 ANATOMY AND PHYSIOLOGY
These are the most abundant granulocytes, Neutrophils
occupying about 40-60% of the total number
of white blood cells in the blood.
• Neutrophils, like all other blood cells, are
formed from the stem cells in the bone
marrow.
• These are highly motile, allowing them to
move in and out of the cells and tissue during
infection quickly.
• Neutrophils are at the front lines of attack
during an immune response and are
 PATHOPHYSIOLOGY
Modifiable Factors

 Presence of other medical conditions

 Poor Lifestyle
 Poor Environment
 Occupation (health workers/frontlines, food&grocery
services).
Non Modifiable Factors
Others:
 Age (60 and above
 Loiterer (tambays)
 Gender (Male)

Virus Exposure
 PATHOPHYSIOLOGY
Virus Exposure

SARS-COV 2 enters the body

Virus will make attachment to type 2 pneumocyte cells of alveoli

S-spike protein of the virus binds to ACE type receptor of type 2

pneumocyte cell and will engulf and taken into the cell.

Virus will release its +SSRNA to cytoplasm

conversion more +SSRNA

 PATHOPHYSIOLOGY
Enzyme proteinase will cleave these polyproteins into different viral components

Copies of +SSRNA and viral components will incorporate making it the

new copies of the virus and emerged outside the cell

Neutrophils will
activate and destroy the
virus

Will release elastase

then will damage
the type 1 and 2
pneumocyte cells.
 PATHOPHYSIOLOGY
Macrophages will stimulate and
secretes cytokines: interlukin 1,
interlukin 6, and TNF alpha

Vasodilation will occur and increase

capillary permeability causing
leakage of plasma to interstitial space
and inside alveoli

Fluids will accumulate inside the alveoli

causes increase in alveolar edema

Surface tension goes up causing the alveoli to collapse

Signs and Symptoms

Primary:
 Fever
 Cough (dry to productive)
 SOB
PATHOPHYSIOLOGY
ADDITIONAL INFO:
 URI sxs (rhinorrhea, sore throat,
headache)
 GI sxs (nausea, vomiting diarrhea)
 Tachycardia
 Tachypnea
 ↓SpO2
 ↑ heart rate, and respiration
 ↓ BP
 Loss of smell and taste

COMPLICATIONS
 Pneumonia
 Acute Respiratory Distress Syndrome (ARDS)
 Multi Organ failure
 Septic shock,
 Death
 LABORATORY PROCEDURE
3 Common Laboratory in Covid-19

1. A complete blood count (CBC) is a blood test. It helps healthcare providers detect a range of
disorders and conditions. It also checks your blood for signs of medication side effects.

2. A c-reactive protein test measures the level of c-reactive protein (CRP) in your blood. CRP is
a protein made by your liver. It's sent into your bloodstream in response to inflammation.
Inflammation is your body's way of protecting your tissues if you've been injured or have an
infection.

3. A chest X-ray uses a focused beam of radiation to look at your heart, lungs and bones.
Healthcare providers use chest X-rays to diagnose or treat conditions like pneumonia,
emphysema or COPD. Chest X-rays are quick, noninvasive tests. Usually, you will know the
results of your X-ray within one to two days.
CLINAL MANAGEMENT AND TREATMENT

Mild to Moderate Disease

Patients with a mild clinical presentation (absence of

viral pneumonia and hypoxia) may not initially require
hospitalization, and most patients will be able to
manage their illness at home. The decision to monitor
a patient in the inpatient or outpatient setting should
be made on a case-by-case basis
CLINAL MANAGEMENT AND TREATMENT
Severe Disease

Some patients with COVID-19 will have severe disease requiring

hospitalization for management. Inpatient management includes
supportive management of the most common complications of
severe COVID-19: pneumonia, hypoxemic respiratory
failure/ARDS, sepsis and septic shock, cardiomyopathy and
arrhythmia, acute kidney injury, and complications from
prolonged hospitalization.
 CLINAL MANAGEMENT AND TREATMENT
Oxygenation

•Intubation- For client who have severe

decompensated acidosis or severe absolute
hypoxemia
 CLINAL MANAGEMENT AND TREATMENT
Oxygenation

•High flow Nasal Cannula- For client

with acute hypoxemic respiratory
failure
 CLINAL MANAGEMENT AND TREATMENT
Oxygenation

•Non invasive positive pressure

ventilation- If HFNC is not available
 MEDICAL MANAGEMENT

MEDICATION
Remdesivir
For treatment of COVID-19
disease in hospitalized adults
and children aged 12 years and
older who weight at least 40
kg. 
 MEDICAL MANAGEMENT
Streptomycin
Part of combination therapy of active tuberculosis; used
in combination with other agents for treatment of
streptococcal or enteroccocal endocarditis, plague,
tularemia, brucellosis.

IM (Adults):
1g/day initially, decreased to 1g 2-3 times weekly; other
infections 250mg 1g q6hr or 5000mg-2g q12hr.
 
IM (Children): 20mg/kg/day (not to exceed 1g/day);
other infections 5-10mg/kg q6hr or 10-20mg/kg q12hr.
 NURSING RESPONSIBILITIES

BEFORE:
• Check the Doctor’s order.
• Verify the right name of the drug and form of the drug.
• Ask if the client has allergy to the medication.
• Check the expiration date before giving the drugs.
• Explain to the client the purpose of the drug.
• Inform the client about the adverse effect.
 NURSING RESPONSIBILITIES
DURING:
 Monitor vital signs
 Verify the patient's identity

AFTER:
 Patient/Family Teaching
 Instruct patient to report signs of hypersensitivity, tinnitus, vertigo,
hearing loss, rash, dizziness, or difficulty urinating.
 Advise patient of the importance of drinking plenty of liquids.
 Document the procedure.
 NURSING MANAGEMENT
Based on assessment data, nursing interventions for COVID-19 should
focus on monitoring vital signs, maintaining respiratory function,
managing hyperthermia, and reducing transmission.
1. Monitor vital signs – particularly temperature and respiratory rate,
as fever and dyspnea are common symptoms of COVID-19.

2. Monitor O2 saturation – normal O2 saturation as measured with

pulse oximeter should be 94 or higher; patients with severe
COVID-19 symptoms can develop hypoxia, with values dropping
low enough to warrant supplemental oxygen.
 NURSING MANAGEMENT

3. Manage fever – use appropriate therapy for hyperthermia, including

adjusting room temperature, eliminating excess clothing and covers,
using cooling mattresses, applying cold packs to major blood vessels,
starting or increasing intravenous (IV) fluids as allowed.

4. Maintain respiratory isolation – isolation rooms should be well-

marked with limited access; all who enter the restricted-access room
should use personal protective equipment, such as masks and gowns.
 NURSING MANAGEMENT

5. Enforce strict hand hygiene – to reduce or prevent transmission of

coronavirus, patients should wash hands after coughing, as should all
who enter or leave the room.

6. Provide information – educate the patient and patient’s family

members of the transmission of COVID-19, the tests to diagnose the
disease, disease process, possible complications, and ways to protect
oneself and one’s family from coronavirus
 • Get vaccinated for Covid-19 - Vaccination is a simple, safe,
and effective way of protecting you against harmful diseases,
before you come into contact with them. It uses your body’s
natural defenses to build resistance to specific infections and
makes your immune system stronger.

Name of Covid-19 vaccines

1. AstraZeneca/Oxford vaccine
2. Johnson and Johnson’s Janssen

3. Moderna
4. Pfizer/BionTech

5. Sinopharm

6. Sinovac
 NURSING CARE PLAN
ASSESSMENT DIAGNOSIS OUTCOME PLANNING IMPLEMENTATION RATIONALE EVALUATION
SUBJECTIVE Hyperthermia After 14 days of Short term: INDEPENDENT: 1. To gain patient’s After 14 days of
DATA: related to viral effective nursing After 8 hours of effective nursing 1. Establish Rapport trust and cooperation. effective nursing
“Limang araw ng infection intervention the intervention the client’s core body 2. Monitor vital signs. 2. Because HR and intervention the client
mataas ang lagnat ko manifested by hot client will be able temperature will be able to subside 3. Advise patient to increase BP increase as was able to maintain
at wala ako panlasa” flushed skin and to maintain from 41° C to 37.5° C. fluid intake. hyperthermia improvement in body
as verblized by the weakness. effective   4. Monitor serum electrolytes progresses. temperature level and
client.   evaporative body Long term: especially serum sodium. 3. Hydration helps the successfully
  cooling as   5. Eliminate excess clothing body to sweat which prevented further
OBJECTIVE DATA: evidenced by After 14 days of effective nursing and covers. is necessary for complications.
 Weakness cooling of skin intervention the client will be able 6. Provide tepid sponge bath evaporative cooling.
 Hot, Flushed and no flush to: and do not use alcohol. 4. Sodium losses can
Skin present.     result to
 Rapid pulse  maintain temperature, pulse   hyperthermia.
 Irritability rate, respiratory rate, and   5. To promote
 Low pitched blood pressure within its   evaporative cooling.
voice normal range. DEPENDENT: 6. TSB helps lowering
    Administer paracetamol as per the body temperature
V/S taken as follows:  verbalized feeling of comfort. doctor’s order. and alcohol cools the
  skin too rapidly
BP - 130/90 mmHg  maintain healthy skin integrity R: Paracetamol is a common causing shivering.
T - 41° C (105.8° F) by the absence of skin painkiller used to treat aches
P – 128 bpm reddening. and pain. It can also be used to
R – 24 cpm   reduce a high temperature.
 
 NURSING CARE PLAN
ASSESSMENT DIAGNOSIS OUTCOME PLANNING INTERVENTION EVALUATION
Subjective: Ineffective Within 14 Short term: 1. Monitor vital signs – particularly temperature and respiratory rate, as Within 2 days
“Nahihirapan breathing days of Within 30 mins of fever and dyspnea are common symptoms of COVID-19. of nursing
2. Monitor O2 saturation – normal O2 saturation as measured with pulse
akong huminga ” pattern nursing nursing interventions oximeter should be 94 or higher; patients with severe COVID-19 intervention
as verbalized by related to intervention the patient respiration symptoms can develop hypoxia, with values dropping low enough to patient was
the client. inflammati patient will and oxygen levels will warrant supplemental oxygen. able to
  on from achieved return to and remain 3. Decrease in oxygen can result to respiratory problems resulting from maintain
the metabolic demands for oxygen during a fever.
Objective: viral and within normal limits. 4. Maintain respiratory isolation – isolation rooms should be well-marked normal
 Cough infection as maintain   with limited access; all who enter the restricted-access room should respiratory
 Using of evidence normal Long term: use personal protective equipment, such as masks and gowns. pattern and
accessory by cough, respiratory Within 2 days of 5. Provide information – educate the patient and patient’s family rate with no
members of the transmission of COVID-19, the tests to diagnose the
muscle using of pattern nursing intervention disease, disease process, possible complications, and ways to protect
adventitious
 Increase work accessory rhythm and the patient will able oneself and one’s family from coronavirus. breath sounds
of breathing muscle, rate with no to prevent the spread Dependent: to
  increase adventitious of infection, learn -Administer oxygen by the method described. auscultation.
Vital Sign: work of breath more about the Oxygen administration aids in correcting low oxygen level.
BP: 130/90 mmHg breathing sounds to disease, improve body -Hooking patient to oxygen up to 10lpm via face mask to maintain 94 to
100 percent oxygen saturation.
HR: 121 bpm auscultation temperature, restore -Perform nasotracheal suctioning as per physician’s order.
RR: 30 cpm before breathing pattern Suctioning is needed when patient are unable to cough out secretions
T: 38.5 °C hospital back to normal and properly due to weakness, thick mucus plugs, or excessive or tenacious
O2 sat- 85% discharge. reduce anxiety. mucus production.
Collaborative: obtain results from the laboratory department on the Hgb of
the client.
Low levels reduce the uptake of oxygen at the alveolar-capillary membrane
and oxygen delivery to the tissue.