You are caring for a newly admitted client with increasing dyspnea and dehydration who has possible avian influenza (bird flu). Which of these prescribed actions will you implement first?
A. Provide oxygen using a non-rebreather mask
B. Infuse 5% dextrose in water at 75ml/hr
C. Administer the first dose of oseltamivir (Tamiflu)
D. Obtain blood and sputum specimens for testing
Correct Answer: A. Provide oxygen using a non-rebreather mask.
Because the respiratory manifestations associated with avian influenza are potentially life-threatening, the nurse’s initial action should be to start oxygen therapy. Patients with respiratory compromise should be placed on supplemental oxygen and monitored closely for signs of deterioration as these patients are at high risk of requiring intubation and mechanical ventilation. The other interventions should be implemented after addressing the client’s respiratory problem.
Option B: Treatment may include hospitalization and supportive care, such as intravenous fluids. Additionally, studies suggest that antiviral drugs help minimize the severity of bird flu in people. However, changes in the virus may limit its effectiveness in the future.
Option C: The World Health Organization released Rapid Advice Guidelines in 2007, outlining consensus treatment recommendations for H5N1 influenza outbreaks. These recommendations include neuraminidase inhibitors (especially oseltamivir) for strongly suspected or confirmed cases of H5N1.
Option D: The preferred source of a sample for testing is a nasopharyngeal swab or aspirate, but other body fluids are usable if the nasopharyngeal swab or aspirate is not available. RT-PCR identification of the virus in viral cultures is the standard of care for diagnosis of AIV, and viral detection is typically possible within a few days of disease onset.