Assessment

HISTORY. Determine if the patient has had contact with an infected person within the past 72 hours. Ask about immunization. Establish a history of fever and chills, hoarseness, laryngitis, sore throat, rhinitis, or rhinorrhea. Elicit a history of myalgia (particularly in the back and limbs), anorexia, malaise, headache, or photophobia. Ask if the patient has a nonproductive cough; in children, the cough is likely to be croupy. Determine if the patient has experienced gastrointestinal symptoms, such as vomiting and diarrhea.

PHYSICAL EXAMINATION. Observe the patient for a flushed face and conjunctivitis. When you inspect the patient's throat, you may note redness of the soft palate, tonsils, and pharynx. Palpate for enlargement of the anterior cervical lymph nodes. The patient's temperature usually ranges from 102°F to 103°F and often rises suddenly on the first day before falling and rising again on the third day of illness. Check if influenza has produced respiratory complications. Note the patient's rate of respirations, which may be increased. Auscultate the patient's lungs for rales.

PSYCHOSOCIAL. The patient who feels very ill and is unable to continue with normal activities should be assured that the illness is self-limiting and that improvement occurs with rest and time.

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