Common Cold
Also Consider: Fever, Shortness of Breath
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Symptoms
Runny Nose (rhinorrhea), nasal congestion (almost always present)
Sore Throat (40% of cases)
Sneezing
Headache
Fever (low-grade, less than 100°F)
Cough (mild, nonproductive)
Fatigue
Goals of Care
Make sure the patient doesn’t have a more serious illness such as COVID-19, influenza or pneumonia. Be aware of other, serious viruses spreading in your community.
Prevent complications like falls or dehydration while they are weak
Prevent the spread to others.
1. Take Vital Signs
Temperature:
Blood Pressure:
Heart Rate:
Respiratory Rate:
Oxygen Saturation:
2. Evaluate Symptoms and Signs
Acute mental status change
Not eating or drinking as much as usual
Acute decline in ADL abilities
Signs of dehydration
Respiratory: New cough, abnormal lung sounds, Accessory muscle breathing, pursed lip breathing, Respiratory distress
Cardiovascular: edema
GI: Nausea, vomiting, diarrhea, constipation
Neurologic changes: consciousness/alertness, orientation, weakness, gait changes (unsteadiness, loss of coordination or balance)
Very low urinary output (<30cc/hr)
Skin: sweats (diaphoresis), cold/clammy/pale skin; rash, infection/cellulitis
Fingerstick glucose (patients with diabetes)
3. Take Action using SBAR Report:
Presence of other, significant symptoms or signs of illness
Refer to appropriate Situation-Specific Evaluation for the identified symptoms and signs.
Notify medical staff & resident representative within the next 16 hours.
Symptoms concerning for a serious virus spreading in your community.
Distressing symptoms despite implementing supportive measures
SBAR Report
Situation: ("Viral Respiratory Infection symptoms concerning for ") (COVID-19, Influenza, other serious virus) ("Distressing common cold symptoms consisting of:") (acute symptoms)
Background:
Reason the patient is in the nursing home (rehab for___, long term care for __).
When the problems started, how severe they are, getting worse or staying the same, what treatments have been used.
Abnormal Vital Signs
General observation of patient condition
Diuretic use & recent dose changes
Very low urinary output (<30cc/hr)
Diet restrictions, fluid restriction, thickened liquids
Similar symptoms in other patient on unit or in facility
Cases of COVID-19, Influenza, or RSV on unit or in facility
Assessment: I am concerned about: __________
Recommendations/Requests:
Acetaminophen, additional analgesics
Avoid cough medicines as they are not effective and can have side effects.
Saline nasal spray for nasal congestion
Ipratropium nasal spray for severe rhinorrhea
Pseudoephedrine for nasal congestion (do not use in patients with anxiety, diabetes, heart disease, hypertension, or prostate disease)
Nasopharyngeal swab for COVID-19, Influenza and RSV PCR testing
Hospitalization if patient requires Airborne isolation
Other:
Clarify expectations for care, interventions, and illness course/prognosis. Repeat any telephone orders back to the provider to ensure that they are correct and complete
4. Implement Management Plan
Implement infection prevention measures - contact the infection prevention nurse for isolation & precaution recommendations.
Monitor vital signs every 8-24 hours for 2-3 days
Offer fluids frequently
Place on Intake & Output monitoring
Monitor meal acceptance
Place on 24-hour report for 2-3 days
Update care plan regarding fall risk, pressure ulcer prevention, assistance needed with ADLs, supervision for safety, restorative needs
Review status and plan of care with designated representative
2025-04-26
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