Microbiology and Parasitology - Lab

Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

LESSON TITLE: CORONA VIRUSE DISEASE 2019 Materials:

(COVID-19), MIDDLE EAST RESPIRATORYSYNDROME (MERS-
Pen, paper, index card, book, and class List
CoV) AND SEVERE ACUTE RESPIRATORY SYNDROME (SARS)

LEARNING OUTCOMES:
Reference:
At the end of the lesson, the nursing student can:
1. Describe what are coronavirus, MERS-CoV and SARS; Navales D., (2010). Handbook of Common
rd
2. Explain the mode of transmission of COVID-19, MERS-CoV Communicable and Infectious Diseases 3
and SARS; Edition, Philippines: C&E Publishing Inc.
3. Identify the etiologic agent COVID-19, MERS-CoV and
SARS; https://www.who.int/emergencies/diseases/no
4. Enumerate the signs and symptoms of COVID-19, MERS- vel-coronavirus-2019
CoV and SARS; and, https://nurseslabs.com/coronavirus-disease-
5. Outline the different nursing management of COVID-19, covid-19
MERS-CoV and SARS.

A. LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Enumerate the ways in preventing Cholera or El Thor.

_________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________.

B.MAIN LESSON (50 minutes)

COVID-19

COVID-19 is the infectious disease caused by the most recently discovered coronavirus. This new virus and disease were
unknown before the outbreak began in Wuhan, China, in December 2019. COVID-19 is now a pandemic affecting many
countries globally.

Corona Virus
⎯ Coronaviruses are a large family of viruses which may cause illness in animals or humans.
⎯ In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more
severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome
(SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19.

Causative Agent: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

⎯ Discovered in January 2020 to be a novel betacoronovirus of the same subgenus as SARS-CoV

Mode of Transmission
⎯ Respiratory infections can be transmitted through droplets of different sizes:
✔ when the droplet particles are >5-10 μm in diameter they are referred to as respiratory droplets,
✔ when there are <5μm in diameter, they are referred to as droplet nuclei.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

⎯ According to current evidence, COVID-19 virus is primarily transmitted between people through respiratory droplets
and contact routes
⎯ Droplet transmission occurs when a person is in in close contact (within 1 m) with someone who has respiratory
symptoms (e.g., coughing or sneezing) and is therefore at risk of having his/her mucosae (mouth and nose) or
conjunctiva (eyes) exposed to potentially infective respiratory droplets.
⎯ Transmission may also occur through fomites in the immediate environment around the infected person.
⎯ In the context of COVID-19, airborne transmission may be possible in specific circumstances and settings in which
procedures or support treatments that generate aerosols are performed; i.e., endotracheal intubation, bronchoscopy,
open suctioning, administration of nebulized treatment, manual ventilation before intubation, turning the patient to the
prone position, disconnecting the patient from the ventilator, non-invasive positive-pressure ventilation, tracheostomy,
and cardiopulmonary resuscitation.

Signs and Symptoms

⎯ Seek immediate medical attention if you have serious symptoms. Always call before visiting your doctor or health
facility.
⎯ People with mild symptoms who are otherwise healthy should manage their symptoms at home.
⎯ On average it takes 5–6 days from when someone is infected with the virus for symptoms to show, however it can
take up to 14 days.

Most common symptoms:

⎯ fever
⎯ dry cough
⎯ tiredness

Less common symptoms:

⎯ aches and pains
⎯ sore throat
⎯ diarrhea
⎯ conjunctivitis
⎯ headache
⎯ loss of taste or smell
⎯ a rash on skin, or discoloration of fingers or toes

Serious symptoms:
⎯ difficulty breathing or shortness of breath
⎯ chest pain or pressure
⎯ loss of speech or movement

Diagnostic Test
⎯ Suspect cases should be screened for the virus with nucleic acid amplification tests (NAAT), such as RT-PCR. It
detects the presence of virus and sensitivity is higher and more accurate the RDT.
⎯ Rapid Diagnostic Tests (RDT) for coronavirus disease, the sensitivity of these tests might be expected to vary from
34% to 80%. It detects COVID-19 antibodies (IgG and IgM)

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Prevention:

STAY HOME.
SAVE LIVES.
Help stop coronavirus

1. STAY home as much as you can

2. KEEP a safe distance
3. WASH hands often
4. COVER your cough
5. SICK? Call ahead

To prevent the spread of COVID-19:

⎯ Clean your hands often. Use soap and water, or an alcohol-based hand rub.
⎯ Maintain a safe distance from anyone who is coughing or sneezing. (at least 3 feet or 1 meter)
⎯ Wear a mask when physical distancing is not possible.
⎯ Don’t touch your eyes, nose or mouth.
⎯ Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze.
⎯ Stay home if you feel unwell.
⎯ If you have a fever, cough and difficulty breathing, seek medical attention.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Treatment:
⎯ To date, there are no specific vaccines or medicines for COVID-19. Treatments are under investigation, and will be
tested through clinical trials.
⎯ Self-care
✔ If you feel sick you should rest, drink plenty of fluid, and eat nutritious food.
✔ Stay in a separate room from other family members, and use a dedicated bathroom if possible.
✔ Clean and disinfect frequently touched surfaces.
✔ Everyone should keep a healthy lifestyle at home. Maintain a healthy diet, sleep, stay active, and make social
contact with loved ones through the phone or internet.
✔ Children need extra love and attention from adults during difficult times.
✔ Keep to regular routines and schedules as much as possible.
✔ It is normal to feel sad, stressed, or confused during a crisis. Talking to people you trust, such as friends and
family, can help. If you feel overwhelmed, talk to a health worker or counsellor.
⎯ Medical treatments
✔ If you have mild symptoms and are otherwise healthy, self-isolate and contact your medical provider or a COVID-
19 information line for advice.

Health workers should:

⎯ Follow established occupational safety and health procedures, avoid exposing others to health and safety risks and
participate in employer-provided occupational safety and health training.
⎯ Use provided protocols to assess, triage and treat patients.
⎯ Treat patients with respect, compassion, and dignity.
⎯ Maintain patient confidentiality.
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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

⎯ Swiftly follow established public health reporting procedures of suspected and confirmed cases.
⎯ Provide or reinforce accurate infection prevention and control and public health information, including to concerned
people who have neither symptoms nor risk.
⎯ Put on, use, take off and dispose of personal protective equipment properly.
⎯ Self-monitor for signs of illness and self-isolate or report the illness to managers, if it occurs.
⎯ Advise management if they are experiencing signs of undue stress or mental health challenges that require support
interventions.
⎯ Report to their immediate supervisor any situation which they have reasonable justification to believe presents an
imminent and serious danger to life or health.

Nursing Management
Nursing management for patients with COVID-19 infection include the following:

Nursing Assessment
Assessment of a patient suspected of COVID-19 should include:
⎯ Travel history. Health care providers should obtain a detailed travel history for patients being evaluated with fever
and acute respiratory illness.
⎯ Physical examination. Patients who have fever, cough, and shortness of breath and who has traveled to Wuhan,
China recently must be placed under isolation immediately.

Nursing Diagnosis
Based on the assessment data, the major nursing diagnosis for a patient with COVID-19 are:
⎯ Infection related to failure to avoid pathogen secondary to exposure to COVID-19.
⎯ Deficient knowledge related to unfamiliarity with disease transmission information.
⎯ Hyperthermia related to increase in metabolic rate.
⎯ Impaired breathing pattern related to shortness of breath.
⎯ Anxiety related to unknown etiology of the disease.

Nursing Care Planning and Goals

The following are the major nursing care planning goals for COVID-19:
⎯ Prevent the spread of infection.
⎯ Learn more about the disease and its management.
⎯ Improve body temperature levels.
⎯ Restore breathing pattern back to normal.
⎯ Reduce anxiety.

Nursing Interventions
Listed below are the nursing interventions for a patient diagnosed with COVID-19:
⎯ Monitor vital signs. Monitor the patient’s temperature; the infection usually begins with a high temperature; monitor
the respiratory rate of the patient as shortness of breath is another common symptom.
⎯ Monitor O2 saturation. Monitor the patient’s O2 saturation because respiratory compromise results in hypoxia.
⎯ Maintain respiratory isolation. Keep tissues at the patient’s bedside; dispose secretions properly; instruct the
patient to cover mouth when coughing or sneezing; use masks, and advise those entering the room to wear masks as
well; place respiratory stickers on chart, linens, and so on.
⎯ Enforce strict hand hygiene. Teach the patient and folks to wash hands after coughing to reduce or prevent the
transmission of the virus.
⎯ Manage hyperthermia. Use appropriate therapy for elevated temperature to maintain normothermia and reduce
metabolic needs.
⎯ Educate the patient and folks. Provide information on disease transmission, diagnostic testing, disease process,
complications, and protection from the virus.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Evaluation
Nursing goals are met as evidenced by:
⎯ Patient was able to prevent the spread of infection.
⎯ Patient was able to learn more about the disease and its management.
⎯ Patient was able to improve body temperature levels.
⎯ Patient was able to restore breathing pattern back to normal.
⎯ Patient was able to reduce anxiety.

Documentation Guidelines
Documentation guidelines for a patient with COVID-19 include the following:
⎯ Individual findings, including factors affecting, interactions, nature of social exchanges, specifics of individual
behavior.
⎯ Cultural and religious beliefs, and expectations.
⎯ Plan of care.
⎯ Teaching plan.
⎯ Responses to interventions, teaching, and actions performed.
⎯ Attainment or progress toward the desired outcome.
MERS-CoV
MERS or Middle East respiratory syndrome is a zoonotic disease (spreads from animals to people) that can cause severe
respiratory illness. It was first identified in Saudi Arabia in 2012 and has infected more than 2,000 individuals worldwide.

Causative Agent:
⎯ Middle East respiratory syndrome (MERS) is caused by a novel coronavirus.
⎯ Coronaviruses are the largest of all RNA viruses, with positive-sense single-stranded RNA genomes of 26-32 kb

Timeline
⎯ Through first reported in Saudi Arabia, it was later identified that the first known cases of MERS occurred in Jordan in
April 2012.
⎯ Most MERS patients developed severe respiratory illness with symptoms of fever, cough, and shortness of breath.
⎯ A large MERS outbreak occurred in the Republic of South Korea linked to a traveler from the Arabian Peninsula in
2015.
⎯ Travel-associated cases have been identified in Algeria, Austria, China, Egypt, France, Germany, Greece, Italy,
Malaysia, Netherlands, Philippines, Republic of Korea, Thailand, Tunisia, Turkey, United Kingdom (UK), and United
States (US).
⎯ CDC has published guidance for health departments and healthcare infection-control programs for investigating
potential cases of MERS and preventing its spread.

Pathophysiology
⎯ Compared with severe acute respiratory syndrome coronavirus (SARS-Cov), MERS-CoV can establish infection in
monocyte-derived macrophages (MDMs) and macrophages.
⎯ The virus induces the release of proinflammatory cytokines, leading to severe inflammation and tissue damage, which
may manifest clinically as severe pneumonia and respiratory failure.
⎯ Vascular endothelial cells located in the pulmonary interstitium may also be infected by MERS-CoV, and, because
MERS-CoV receptor DPP4 is expressed in different human cells and tissues, dissemination of the infection may
occur.
⎯ Interestingly, lymphopenia has been noted in most patients infected with MERS-CoV, as was noted in SARS
infections.
⎯ This is due to cytokine-induced immune cell sequestration and release and induction of monocyte chemotactic
protein-1 (MCP-1) and interferon-gamma-inducible protein-10 (IP-10), which suppresses the proliferation of human
myeloid progenitor cells.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Statistics and Incidences

About 3 or 4 out of every 10 patients reported with MERS have died.
⎯ In May 2014, CDC confirmed two unlinked imported cases of MERS in the United States—one to Indiana, the other to
Florida; both cases were among healthcare providers who lived and worked in Saudi Arabia; both traveled to the U.S.
from Saudi Arabia, where scientists believe they were infected.
⎯ Since 2012, 2,374 laboratory-confirmed cases of infection with MERS-CoV have been reported to the World Health
Organization (WHO), including at least 823 related deaths.
⎯ Twenty-seven countries have reported MERS cases.
⎯ On the Arabian Peninsula, countries include Bahrain, Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia,
United Arab Emirates (UAE), and Yemen.
⎯ Other countries reporting travel-associated MERS include Algeria, Austria, China, Egypt, France, Germany, Greece,
Italy, Malaysia, Netherlands, Philippines, Republic of Korea, Thailand, Tunisia, Turkey, United Kingdom (UK), and the
United States.
⎯ The vast majority of these cases have so far occurred in the Kingdom of Saudi Arabia.
⎯ The largest MERS outbreak outside of Saudi Arabia occurred in 2015 in the Republic of Korea; the outbreak involved
186 confirmed cases and caused 36 deaths.
⎯ The outbreak sparked quarantine of more than 5,000 individuals and the closure of 2,000 schools before ending.

Clinical Manifestations
Physical examination findings associated with MERS-CoV infection are similar to those presenting with any flu-like
symptoms, including the following:
⎯ Fever
⎯ Rhinorrhea, mostly clear
⎯ Pulmonary findings, including hypoxemia, rhonchi, and rales (some patients may have a normal auscultation)
⎯ Tachycardia
⎯ Hypotension may occur with severe illness, reflecting systemic inflammatory response syndrome

Assessment and Diagnostic Findings

⎯ rRT-PCR assay. FDA issued an Emergency Use Authorization (EUA) on June 5, 2013, to authorize use of CDC’s
2012 real-time reverse transcription–PCR assay to test for MERS-CoV in clinical respiratory, serum, and stool
specimens.
⎯ Serology. Serologic testing for MERS-CoV is available as a research/surveillance test from the CDC; it is not
considered a diagnostic test but may offer valuable epidemiologic data; it must be ordered in consultation and with
approval of CDC via the EOC.
⎯ Laboratory studies. Laboratory findings at presentation may include leukopenia, lymphopenia, thrombocytopenia,
and elevated lactate dehydrogenase levels; these are most likely with increasing severity of illness.
⎯ Imaging studies. Chest imaging findings are abnormal in more than 80% of MERS cases; ground-glass opacity
(GGO) is found in over 60% of chest radiographs, with about 20% incidence of consolidation; some infiltrates may be
nodular.

Medical Management
⎯ Management of the Middle East respiratory syndrome (MERS) coronavirus (MERS-CoV) infection is supportive; this
includes hydration, antipyretic, analgesics, respiratory support, and antibiotics if needed for bacterial superinfection.

Prevention
⎯ No MERS-CoV vaccine is commercially available; prevention of infection in areas where MERS-CoV is being actively
transmitted requires avoidance of potentially infectious secretions and careful attention to hand and respiratory
hygiene.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Nursing Management
Nursing care for a patient with MERS-CoV include the following:

Nursing Assessment
Assessment of a patient with MERS-CoV include:
⎯ History. A high index of suspicion is necessary to suspect MERS, and a travel and exposure history is essential to the
diagnosis; keys to the case definition of MERS is a history of residence or travel in the Arabian Peninsula, in countries
where MERS-CoV is known to be circulating in dromedary camels, or where human infections have recently occurred
and exposure within the incubation period of 14 days.
⎯ Physical exam. Clinical manifestation is indistinguishable from other common respiratory viruses and may range from
no symptoms to rapidly progressive multiorgan failure and death.

Nursing Diagnosis
Based on the assessment data, the major nursing diagnosis for a patient with MERS-CoV include the following:
⎯ Infection related to failure to avoid pathogen secondary to exposure to MERS-CoV.
⎯ Deficient knowledge related to unfamiliarity with disease transmission information.
⎯ Hyperthermia related to increase in metabolic rate.
⎯ Ineffective airway clearance related to excessive production of pulmonary secretions.
⎯ Anxiety related to unknown etiology of the disease.

Nursing Care Planning and Goals

The major nursing care plan goals for a patient with MERS-CoV are:
⎯ Prevent the spread of infection.
⎯ Learn more about the disease and its management.
⎯ Reduce increase in temperature.
⎯ Provide a patent airway.
⎯ Reduce anxiety.

Nursing Interventions
Nursing interventions for the patient with MERS-CoV include the following:
⎯ Monitor vital signs
✔ Monitor the patient’s temperature; the infection usually begins with a high temperature
✔ Monitor the respiratory rate of the patient as shortness of breath is another common symptom.
⎯ Educate the patient and folks
✔ Include the patient and folks in creating the teaching plan, beginning with establishing objectives and goals for
learning at the beginning of the session
✔ Provide clear, thorough, and understandable explanations and demonstrations; and give information with the use
of media.
✔ Use visual aids like diagrams, pictures, videotapes, audiotapes, and interactive Internet websites.
⎯ Reduce increase in temperature
✔ Adjust and monitor environmental factors like room temperature and bed linens as indicated
✔ Encourage ample fluid intake by mouth
✔ Eliminate excess clothing and covers, and give antipyretic medications as prescribed.
⎯ Ensure patent airway
✔ Teach the patient the proper ways of coughing and breathing. (e.g., take a deep breath, hold for 2 seconds, and
cough two or three times in succession)
✔ Position the patient upright if tolerated, and encourage patient to increase fluid intake to 3 liters per day within the
limits of cardiac reserve and renal function.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

⎯ Reduce anxiety
✔ Use presence, touch (with permission), verbalization, and demeanor to remind patients that they are not alone
and to encourage expression or clarification of needs, concerns, unknowns, and questions.
✔ Accept patient’s defenses; do not dare, argue, or debate
✔ Converse using a simple language and brief statements; and allow the patient to talk about anxious feelings and
examine anxiety-provoking situations if they are identifiable.

Evaluation
Nursing evaluation of goals for a patient with MERS-COV are met as evidenced by:
⎯ Prevention of the spread of infection.
⎯ Acquired knowledge about the disease and its management.
⎯ Reduction in levels of temperature.
⎯ Patent airway achieved.
⎯ Reduction in anxiety.

Severe Acute Respiratory Syndrome (SARS)

Severe acute respiratory syndrome (SARS) is a viral respiratory disease caused by a SARS-associated coronavirus. It
was first identified at the end of February 2003 during an outbreak that emerged in China and spread to 4 other countries.
First case of SARS in the Philippines was on April 11, 2003.

Causative Agent: SARS-associated coronavirus (SARS-CoV).

Incubation Period:
⎯ When SARS was occurring, its symptoms appeared 2–7 days after a person was exposed to the virus, but they could
also take up to 10 days.

Clinical Criteria:
⎯ Asymptomatic or mild respiratory illness with a body temperature of >100.4F(>38C)
⎯ One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty in breathing or hypoxia)

Epidemiologic Criteria:
⎯ Travel w/in 10 days of the onset of symptoms to an area with current or previously documented or suspected
community transmission of SARS.
⎯ Close contact within 10 days of the onset of symptoms with a person known or suspected to have SARS.

Mode of Transmission:
⎯ SARS is an airborne virus and can spread through small droplets of saliva
⎯ Direct contact with mucous membranes (especially those of the eyes, nose, and mouth)
⎯ Indirect through infected fomites
⎯ Casual and social contact
⎯ Contamination of inanimate materials with saliva, tears, urine, stools

Symptoms
⎯ The first symptom was a high fever of more than 100.4°F (38.0°C). Other mild respiratory symptoms were similar to
those of flu.
Other early symptoms included:
⎯ aches
⎯ chills
⎯ diarrhea in 10–20% of people
⎯ These symptoms developed over the course of 7 days.

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

After 7–10 days, the person might then have noticed:

⎯ a dry cough
⎯ shortness of breath
⎯ low oxygen levels in the body known as hypoxia
⎯ Most people with SARS developed pneumonia while some had long-term damage to their liver, kidneys, and lungs.

Treatment
⎯ SARS is a reportable disease and a medical emergency.
⎯ No drugs, including antibiotics, appeared to be effective against SARS.
⎯ Instead, healthcare providers offered supportive care, including the use of medications to relieve symptoms, such as
fever and a cough.
⎯ In the hospital, some people needed a ventilator to help them breath

Prevention
As with other infectious diseases, some simple steps would help prevent the spread of SARS-CoV if it were to occur
again. These include:
⎯ washing hands frequently or cleaning with an alcohol-based detergent
⎯ avoiding touching the eyes, mouth, and nose with unclean hands
⎯ covering the mouth and nose with a tissue when coughing or sneezing
⎯ avoiding sharing food, drinks, and utensils
⎯ staying at least 3 feet away from other people
⎯ regularly cleaning surfaces with disinfectant

Similarly, anyone with symptoms of SARS would limit interaction with other people until 10 days after their symptoms
improve.

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 30 minutes for this activity:

Multiple Choice

1. A client who has recently traveled to China comes to the emergency department (ED) with increasing shortness of
breath and is strongly suspected of having a COVID-19. Which of these prescribed actions will you take first?
a. Place the client on contact and airborne precautions
b. Obtain blood, urine, and sputum for cultures
c. Administer methylprednisolone (Solu-Medrol) 1 gram/IV
d. Infuse normal saline at 100ml/hr
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

2. You are preparing to leave the room after performing oral suctioning on a client who is on contact and airborne
precautions. In which order will you perform the following actions?

1. Take off the gown.

2. Remove N95 respirator.
3. Perform hand hygiene.
4. Take off goggles.
5. Remove gloves.

a. 5, 4, 1, 2, 3
b. 4, 5, 2, 1, 3
c. 1, 2, 4, 5, 3
d. 2, 4, 2, 1, 3
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

3. A 10-year-old client contracted COVID-19 when traveling abroad with her parents. The nurse knows she must put on
personal protective equipment to protect herself while providing care. Based on the mode of transmission, which personal
protective should the nurse wear?
a. Gloves
b. Gown and gloves
c. Gown, gloves, and mask
d. Gown, gloves, mask, and eye goggles or eye shield
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

4. To prevent COVID-19 social distancing must be followed. The safe distance to prevent the transmission of the virus is?
a. 1 foot
b. 6 meters
c. 6 feet
d. 1 meter
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

5. Which of the following is the most important purpose of handwashing?

a. To promote hand circulation
b. To prevent the transfer of microorganism
c. To avoid touching the client with a dirty hand
d. To provide comfort
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

6. In which order will the nurse perform the following actions as she prepares to leave the room of a client with airborne
precautions after performing oral suctioning?
1. Take off goggles
2. Take off gown
3. Remove gloves
4. Remove N95 respirator
5. Perform hand hygiene

a. 1, 2, 3, 4, 5
b. 2, 1, 4, 3, 5
c. 3, 4, 1, 2, 5
d. 4, 3, 2, 1, 5.
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

7. The nurse assessed the client and noted shortness of breath and recent trip to China. The client is strongly suspected
of having Middle East Respiratory Syndrome (MERS-CoV). Which of these prescribed actions will the nurse take first?
a. Place the client on airborne and contact precautions
b. Introduce normal saline at 75 mL/hr
c. Give methylprednisolone (SOLU-Medrol) 1 g intravenously (IV)
d. Take blood, urine, sputum cultures
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

8. The school nurse is asked which action will take to have the most impact on the incidence of infectious diseases in
school. The correct response is:
a. Grant written information about infection control to all parents
b. Ensure that students are immunized according to national guidelines
c. Make soap and water easily accessible in the classrooms
d. Educate students on how to cover their mouths when coughing
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

9. What is the most effective treatment of SARS?

a. Antibiotics
b. Antiviral
c. Bronchodilators
d. No specific treatment
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

10. The following are the clinical manifestations of SARS. EXCEPT?

a. Sudden onset of high-grade fever, greater than 42C
b. Headache and body aches
c. Mild respiratory symptoms at the onset
d. Two days after: dry cough and respiratory difficulty.
ANSWER: ________
RATIO:___________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

2. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

3. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

4. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

5. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________
6. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

7. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

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 Microbiology and Parasitology - Lab
Module #9 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

8. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

9. ANSWER: ________
RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

10. ANSWER: ________

RATIO:_______________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________

C. LESSON WRAP-UP (5 minutes)

AL Activity: CAT: 3-2-1

Instructions:
1. As an exit ticket at the end of the class period
2. Record three things you learned from the lesson.
3. Next, two things that you found interesting and that you’d like to learn more about.
4. Then, record one question you still have about the lesson.
Three things you learned:
1. __________________________________________________________________________________
2. __________________________________________________________________________________
3. __________________________________________________________________________________
Two things that you’d like to learn more about:
1. __________________________________________________________________________________
2. __________________________________________________________________________________
One question you still have:
1.___________________________________________________________________________________

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