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What Nurses Need to know About Sequelae
- Discover sequelae types, causes, examples, and associations with COVID-19.
- Explore how sequelae shows up in everyday interactions with patients.
- Learn the best strategy nurses can use to manage treating patients with sequelae.
Charmaine Robinson
MSN-Ed, BSN, RN
Although primarily associated with COVID-19, nurses often come across sequelae in daily interactions with patients – whether they realize it or not. Have you ever accidentally bumped into something and ended up with an abrasion that became a scar?
Do you know that the scar is considered a sequela of your injury? Who knew something so simple could sound so complicated?
In this article, nurses can learn about sequelae and the various types that may be present in patients under their care.
Types of Sequelae
Sequelae (sequela–singular) are conditions or complications that result from illnesses, injuries, or medical interventions. Postoperative tissue damage? Permanent adverse effects from a medication? Post-stroke complications?
Think “sequelae.” Nurses manage the care of patients with multiple comorbidities and patients with sequelae resulting from other conditions.
For example, a nurse may care for a patient with kidney disease. After obtaining a detailed patient history, the nurse may find that the kidney disease results from another condition – chronic high blood pressure.
In this example, kidney disease is a sequela of chronic high blood pressure. In a sense, kidney disease is the “sequel” to chronic high blood pressure.
Examples of Sequelae
A nurse may come across various types of sequelae in the care of patients. Sequelae can include symptoms, diseases, syndromes, conditions, and complications. While sequelae are typically long-term, they can be anything ranging from a superficial scar to permanent paralysis.
Sequelae can be physical, mental, or even emotional. It can be mild, moderate, or severe.
Here are several examples of sequelae:
Sequelae caused by illness or disease:
- Difficulty swallowing after stroke
- Vision loss from unmanaged diabetes
- Irregular heart rhythms after heart attack
- Developmental problems related to fetal alcohol syndrome
Sequelae caused by injury or trauma:
- Anxiety disorder related to a traumatic event
- Burn scars
- Chronic headaches related to a prior head injury
- Tissue damage caused by a sports injury
Sequelae caused by a medical intervention:
- Blood transfusion reaction
- Surgical scars
- Permanent hair loss caused by chemotherapy
- Nerve damage caused by a vaccine
Everyday Interactions with Patients
Whether realized or not, nurses manage sequelae in everyday interactions with patients. Many of the illnesses and conditions a nurse may see in a patient’s medical history may be identified as sequelae. Many patients’ medications and therapies target sequelae that is associated with various conditions like cancer, stroke, heart attack, diabetes, and infectious diseases like COVID-19.
Sequelae and COVID-19
The term “sequelae” is not commonly used; however, one of its most common associations today is COVID-19. Also referred to as “long COVID” or “post-COVID syndrome,” sequelae of COVID include health problems and complications that occur after the onset of the disease. Estimates show that about 20 million people worldwide have recovered from COVID-19. However, there are now reports of patients experiencing long-term complications from the disease, some severe.
In one study, the most common long-term COVID-19 complications (or sequelae) were cardiovascular, pulmonary, and neurological-related. These included myocardial injury (i.e., inflammation and myocarditis), thrombolytic disease, pulmonary dysfunction (i.e., interstitial thickening and fibrosis), encephalitis, and seizures. These occurred three to six months after the onset of COVID-19. Other symptoms included headache, vertigo, loss of sense of smell and taste, significant mood swings, and brain fog.
In another report, researchers studied the effects of COVID-19 one year after the onset of the disease. Results revealed that patients experienced fatigue/weakness, breathing problems, and joint problems. Depression, anxiety, memory loss, difficulty concentrating, and insomnia were also listed. The study also found that women were more likely to experience sequelae of COVID-19 after a year.
The Bottom Line
While there is still more to be studied about the sequel of COVID-19, nurses will likely continue to come across patients experiencing the disease’s long-term effects. When nurses care for patients who suffer from the long-term complications of any illness or disease, symptom management may be the best strategy, as a cure may not be feasible if the damage is severe.
Nurses should be knowledgeable about sequelae and help patients understand how to manage and cope with their disease. Nurses should also educate patients on the modifiable risk factors for sequelae so that appropriate changes can be made.
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