COVID-19 Paper
Discuss the physical assessment, pharmacology, and therapeutic interventions for a patient presenting COVID-19.
Be sure to write using APA format. Cite at least two peer-reviewed, reliable sources that you used to develop your plan. Provide both in-text citations and full APA citations of the sources.
Sample Paper
Discuss the physical assessment, pharmacology, and therapeutic interventions for a patient presenting COVID-19.
COVID-19 is a viral respiratory infection transmitted through close contact with infected individuals due to the inhalation of infected droplets. The virus can also be spread as a result of contact with infected objects. The physical assessment of COVID-19 is mainly focused on the respiratory system since it is the primary system affected by the virus, and therefore it is easier to diagnose the infection. The physical assessment should be conducted in a private room, and the care provider should be wearing PPE due to the risk of aerosol transmission. The assessment should begin with the general appearance of the patient (Sanders et al., 2020). Asymptomatic patients with mild infections will appear healthy, while those with severe infections will appear lethargic, dehydrated, short of breath, and cyanosis might be present around the extremities and the face. Most patients will be febrile, and the body temperature will be greater than 100.4°F. Pulse rate will be within normal range; however, sinus tachycardia and irregular heart rhythms will be present in patients with severe infections. Increased respiratory rate will be noted more than 16 beats per minute (Kamal et al., 2021).
Skin examination can reveal the following lesions: erythematous maculo-papular, pseudo‐chilblain lesions on the fingers, and acro-ischemic lesions on the toes and fingers due to cyanosis. HEENT examination among patients with a severe infection will reveal edema associated with kidney damage causing fluid retention. Findings will include papilledema on the eyes, runny and congested nose, throat congestion, and edema. Neck examination might reveal palpitations due to increased jugular pressure. Percussion of the thoracic region will result in tympanic notes. Auscultation will indicate decreased breath sounds, and rales might be present or not present. Some patients might report abdominal pain; however, it is not very common. Palpation on the right iliac fossa will reveal tenderness without any evidence of acute appendicitis. Extremities are likely to exhibit edema, especially among patients with severe infections due to kidney damage (Kamal et al., 2021).
Currently, there is no effective cure against the virus. COVID 19 virus is a single-stranded RNA virus. It binds to the ACE2 receptor on the cells using the spike proteins. Once it is bound to the ACE2 receptors, it uses type 2 transmembrane serine protease to enter the cell via the S protein. Once inside the cell, viral polyproteins are synthesized used to further develop viral proteins, which are then released, infecting more cells. Current recommended medications focus on interrupting at least one stage of the viral replication of the virus. Among the current recommended medications include Ritonavir-Boosted Nirmatrelvir. The medication is a protease inhibitor; it inhibits MPRO, essential in cleaving viral polyproteins. The drug has been shown to be effective against all coronaviruses that affect human beings. Sotrovimab is recommended for emergency use. It binds to a conserved epitope within the receptor; the drug is, however, a monoclonal antibody and increases the risk of rapid mutations; therefore, its use is limited to emergency use. Remdesivir has inhibitory properties against RNA polymerase (National Institute of Health, 2022).
The health status of the patients determines therapeutic interventions for COVID-19 patients. For mild infections, patients do not require hospital admissions. Therapeutic interventions include maintaining a balanced diet, ensuring fluid intake, facilitating deep breathing exercises, and humming to relieve the symptoms. Psychotherapy is also initiated to help the patient deal with the impact of control methods such as isolation (Khalili et al., 2020). For patients with severe infections and those admitted to hospitals, a wide range of therapy is required to restore them to normal functioning. It includes speech therapy, physical therapy to restore and strengthen muscles for daily function. Psychotherapy is also provided to restore the emotional well-being of the patient and to help them deal with the changes in their life (Kamal et al., 2021).
References
Kamal, M., Abo Omirah, M., Hussein, A., & Saeed, H. (2021). Assessment and characterisation of post‐COVID‐19 manifestations. International journal of clinical practice, 75(3), e13746. https://onlinelibrary.wiley.com/doi/full/10.1111/ijcp.13746
Khalili, M., Chegeni, M., Javadi, S., Farokhnia, M., Sharifi, H., & Karamouzian, M. (2020). Therapeutic interventions for COVID-19: a living overview of reviews. Therapeutic advances in respiratory disease, 14, 1753466620976021. https://journals.sagepub.com/doi/full/10.1177/1753466620976021
National Institute of Health, (2022) Therapeutic Management of Nonhospitalized Adults With COVID-19 Retrieved from: https://www.covid19treatmentguidelines.nih.gov/management/clinicalmanagement/nonhospitalized-adults–therapeutic-management/
Sanders, J. M., Monogue, M. L., Jodlowski, T. Z., & Cutrell, J. B. (2020). Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. Jama, 323(18), 1824-1836. https://jamanetwork.com/journals/jama/fullarticle/2764727/
