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22 - Dengue Hemorrhagic Fever
22 - Dengue Hemorrhagic Fever
22 - Dengue Hemorrhagic Fever
I. Definition
II. Etiology
Other symptoms:
1. Nausea and vomiting
2. Loss of appetite
3. Increased sensation to touch
4. Change in taste sensation
5. Symptoms maybe milder in children than in adults
6. The acute phase of illness can last for 1 week followed by a 1 to 2
week period of recovery period that is characterized by weakness,
malaise and loss of appetite.
In patient with DHF, the haematocrit is increased and the platelet count is
decreased.
Defferential
Count
Neutrofil 0.46 0.42 0.50-0.70
Lemphocyte 0.43 0.38 0.20-0.40
Eosinophil 0.00 0.02 0.00-0.01
Monocytes 0.11 0.08 0.00-0.09
Atyphical
lymphocytes
Basophil 0.00 0.02 0.00-0.01
V. Management
1. Close monitoring of vital signs in critical period (between day 2 to day
7 of fever) is vital
2. Increased oral fluid intake is recommended to prevent dehydration
3. Supplementation with intravenous fluids may be necessary to prevent
dehydration and significant concentration of the blood if the patient is
unable to maintain oral intake
4. A platelet transfusion is indicated in rare cases if the platelet level
drops significantly (below 20,000) or if there is significant bleeding
5. The presence of melena may indicate internal gastrointestinal bleeding
requiring platelet and/or red blood cell transfusion.
6. Aspirin and non-steroidal anti-inflammatory drugs should be avoided
as these drugs may worsen the bleeding tendency associated with
some of these infections
7. Patients may receive antipyretic preparations to deal with these
symptoms if dengue is suspected.
NURSING DIAGNOSIS RATIONALE NURSING RATIONALE EVALUATION
INTERVENTIONS
Date: July 13, 2009 Definition: 1. Monitor vital signs -decreased pulse Goal met
pressure and blood
pressure may signifies
Risk for injury related to At risk of injury as a bleeding The client was freed
decreased platelet result of environmental from any physical injury
count conditions interacting and managed and
with the individual’s 2.Administer medication -to make sure that the minimized
adaptive and defensive and infusion using “5 infusions and complications of
resources. rights” system (right medications are decreased platelet as
patient, right administered to the evidenced by:
Objective cue: exact patient
medication, right route,
Infection of dengue right dose, right time)
virus (flavivirus) -The client don’t
– Decreased through the bite of had any physical
platelet count of Aedes aegypti mosquito injury
3. Inform and educate
60x10^g/L -to make the client
client regarding all
aware to the medication
treatment and -The client was
and treatment
medication freed from
Goals: complications of
Dengue virus attack decreased
The client will be free lymphocytes and lymph -that may contribute to
from any physical injury 4. Discuss importance platelet
tissue the occurrence of injury
and manage and of self monitoring of
minimize complications conditions
of decreased platelet.
-to avoid sever bleeding
Ref:
- to decreased any
Marilynn E. Doenges, chance of physical
Nurses Pocket Guide, 7. Encourage the client injury in the nose or
11th edition, 2008, page not to blow the nose or nasal cavity
414 insert objects in the
nose
-Use soft bristled
http://www.cdc.gov toothbrush, no flossing,
8.Teach the client to no dental extraction, no
/ncidod/dvbid/dengue/ hard food, make sure
avoid mouth trauma
slideset/set1/i/slide05.ht dentures fit
m
8. management of the
diet -to know what are the
Diarrhea, fever, chills, things to be avoided.
sometimes blood or
mucus in the stools.
Vomiting less common.
9. prmote bed rest -Rest decreases
intestinal motility and
reduces metabolic rate
Ref:
Marilynn E. Doenges,
Nurses Pocket Guide,
11th edition, 2008