Answer

It is a known fact that people’s immune systems get weaker with age. As a result, people 65 years and older bear significant burden of flu and flu related health complications. According to Nguyen & Noymer (2013), between 70% and 80% of flu-related deaths occur among patients above 65. In this paper, effective nursing practices in the management of flu are discussed, with particular focus on the role of nurses in the provision of patient-centered nursing care, infection control practices, interdisciplinary care, and patient safety. In order to understand flu more clearly, Mr Esi Azikiwe, an 88 year old African immigrant, is considered in light of flu-related complications he has developed. This essay also includes a detailed analysis of influenza, its mode of spread and risks in relation to the elderly; infection control precautions needed in a nursing home setting and why these are necessary; other risk assessments and nursing cares needed, including safety and cultural aspects for Mr. Esi Azikiwe; and other health team involvement that may be needed and a rationale for this. In light of high risk of death attributable to flu complications, old patients are found to be most vulnerable to flu, and therefore, flu management interventions should be channeled to their treatment.

            Influenza or flu is a highly infectious disease of the upper respiratory tract typified by fever, runny nose, sore throat, and muscle pains (Gravenstein et al., 2016). There are three known modes of transmission of influenza: direct contamination by infected persons through objects, contact with infected individuals, and by inhalation of cough droplets from infected persons. The third transmission mode, inhalation of infected aerosols from infected individuals is by far the most potent of the three modes of transmission; as such droplets can stay suspended in the air for long periods to initiate new infections. Contamination via direct contact with infected objects may be necessitated by flu-laden nasal secretions. Further, touching of surfaces with infected hands can propagate the virus, as it provides latency, and a breeding ground for new infections (Gravenstein et al., 2016). In the management and control of flu in elderly patients, it is imperative that an understanding of the major risk factors be considered. For elderly patients, above 65 years, age in itself is a significant risk due to weakened immunity. Nevertheless, there are important bearings on health of seniors that flu portends. First, the risk of developing pneumonia, a well-known flu-related infection, increases for elderly patients. Other risks associated with influenza, subtle, yet life threatening. Among them are the risk of heart attack and stroke (Gravenstein et al., 2016). In elderly patients, the former increases by 3-5 times while the risk of stroke is elevated by 2-3 times in the initial two weeks following infection (Cheng, Bohr, & de Cabo, 2010). A consideration of the three risks puts increases the risk of dying in flu patients up to 6 times.

            Influenza, in its very nature, is a community disease. Consequently, and owing to close proximity between patients and healthcare Providers (HCPs), the hospital setting provides the most optimum conditions for furtherance of spread of flu (Young & Koopsen, 2010). Control precautions may typically involve a number of measures. First, there is need to promote and administer seasonal influenza vaccine. High vaccination rates for both HCPs and patients are a first step in the control of flu. Secondly, HCPs should perform aerosol-generating procedures with caution. These may include procedures such as bronchoscopy, sputum induction, and cardiopulmonary resuscitation (CPR) which may expose HCPs to higher concentrations of infectious aerosols. The number of HCPs involved in such procedures should be limited to curtail spread of flu. Third, strict adherence to droplet precautions, through measures such as isolation of infected patients in a separate room, and restricting entry to HCPs with nose masks is a vital step in flu infection control (Rainwater‐Lovett, Chun, & Lessler, 2014). The said period may determined by the severity of the flu outbreak. Further, routine disinfection of wards and shared equipment such as hospital toilets should be strictly observed. Fourth, Health facilities should set and adhere to strict standard precautions. Included in this sphere are practices such as observance of hand hygiene through regular hand washing, wearing of gowns and gloves for contact with body fluids, secretions, excretions, and other potentially contagious material. Use of same gloves for the same patient, or washing for reuse should be avoided as well. Furthermore, it is important to observe and examine ill healthcare personnel. These may be effected through exclusion of work from the onset of flu-like symptoms, observance of respiratory hygiene, and cough etiquette. Finally, it may be necessary to control access into wards to forestall new infections or cross-contamination of visitors and HCPs.

            Apart from the possible emergence of non-communicable diseases such as pneumonia, stroke, and heart conditions, in the influenza matrix, there are other risk factors which may potentially exacerbate Mr. Esi’s condition. The risk of pressure injury may ensue, as sensory perception is impaired. This may lead to poor response  to pressure loading, leading to greater possibility of injury due to friction, shear, and in some cases, pressure ulcers, and sores. An assessment of malnutrition indicators such as unprecedented weight loss, unusual body mass index, decreased intake of food, diet deficiency could point to dietary deficiencies (Influenza, 2013). Nutritional status of elderly patients should also be assessed for abnormalities. Another concomitant of old age are the physiological changes, in the form of renal and hormonal changes, resulting in increased dehydration associated with aging often result in either of two possible outcomes or both: Renal water loss, and low levels of sodium and renal sodium loss (Andreatta, & Marzano, 2012). Incidentally, older persons experience less thirst, further decreasing their ability for water intake. Fluid balance charts, includes rationale for these assessments.

Safety and Cultural Aspects of Care

            Provision of patient-centered care confers on healthcare providers the responsibility of providing optimized health services for the patient at reasonably low prices. Through the patient-centered approach, health providers can leverage on the expertise of a pool of healthcare professionals to provide wide ranging services from consultancy, to actual treatment (Stuck, & Iliffe, 2011). For Mr Esi, owing to his advanced age, and flu-related complications, can count on the services of an infectious disease specialist doctor, to monitor and arrest potential slide to stroke, heart disease or pneumonia. The pharmacist can complement the doctors by prescribing the right medication; the dietician will then ensure that the patient’s food is nutritionally useful. The physiotherapist can then follow up with a strict but measured physical exercise regime. The occupational therapist will be handily waiting to modify Mr Esi’s home environment so as to enable him to live his life normally. Finally, the social worker will greatly enhance the patient’s wellness through regular follow-ups and counseling services.

            Careful consideration of old influenza patients’ unique circumstances, and other risk factors, and particularly Mr. Esi’s, shows a need for concerted effort to provide healthcare for old patients, who show high proclivity for infectious diseases due to their impaired immunity (Ellis, Whitehead, O’Neill, Langhorne, & Robinson, 2011). Owing to the infectious nature of flu, and the fact that it spreads fast through the air, and infected surfaces, elderly people should be prioritized in seasonal vaccinations. It is also necessary that care of ill patients should include procedures such as utmost care through appropriate protective clothing, masks, and gloves (Influenza, 2013). Other risks factors that may need to be assessed were considered such as assessment of injury through pressure, nutritional status,   and fluid balance in the body, are considered as essential (World Health Organization, 2011). The involvement of other healthcare professionals in the provision of health to elderly patients has been found to be key as it forms the basis of integrated healthcare model. This model is particularly useful for the elderly since they are vulnerable to myriad diseases. Therefore, focused health services in the management of infectious diseases such as influenza, should be made available to old patients such as Mr. Esi, because of their vulnerabilities and frailness. Granted, reduced body mass may result from reduced muscle mass, weight loss in elderly patients may be difficult to notice. However, an assessment of nutrition is essential component of Mr. Esi’s treatment plan.