Nursing Prioritization Delegation Assignment Q 69

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A newly admitted client is suspected to have avian influenza (“bird flu”) due to increasing dyspnea and dehydration. Which of these prescribed actions will the nurse implement first?

  

     A. Give first dose of oseltamivir (Tamiflu)

     B. Instill 5% dextrose in water at 100 mL/hr

     C. Collect blood and sputum specimens for testing

     D. Start oxygen using a non-rebreather mask

    

    

Correct Answer: D. Start oxygen using a non-rebreather mask

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The nurse’s first action should be to start oxygen therapy because the respiratory manifestations linked to avian influenza are most likely life-threatening. 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.

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Option A: The World Health Organization released Rapid Advice Guidelines in 2007, outlining consensus treatment recommendations for H5N1 influenza outbreaks. Similar recommendations can likely be used in avian influenza outbreaks due to other strains of the virus. These recommendations include neuraminidase inhibitors (especially oseltamivir) for strongly suspected or confirmed cases of H5N1.

Option B: Treatment of avian influenza usually consists of supportive care and antiviral medications. The majority of care should aim at managing the sequelae of infection. For instance, patients with volume loss or possible electrolyte imbalances should receive volume resuscitation and treatment to correct imbalances.

Option C: 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. Because the infection carries high mortality risk, a negative rapid antigen test should not rule out AIV infection when high suspicion exists.

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