Wednesday, September 22, 2010

Nursing Care Plan for Dengue Hemorrhagic Fever (DHF)

Nursing Care Plan for Dengue Hemorrhagic Fever (DHF)

Dengue Hemorrhagic Fever

Dengue hemorrhagic fever is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes aegypti).


Causes

Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunityimmunity to a different dengue virus type plays an important role in this severe disease.

Worldwide, more than 100 million cases of dengue fever occur every year. A small number of these develop into dengue hemorrhagic fever. Most infections in the United States are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone who has not traveled.

Risk factors for dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.


Symptoms

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restlessrestless, and sweaty. These symptoms are followed by a shockshock -like state.

Bleeding may appear as tiny spots of blood on the skin (petechiaepetechiae) and larger patches of blood under the skin (ecchymosesecchymoses). Minor injuries may cause bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:

* Decreased appetite
* Fever
* Headache
* Joint aches
* MalaiseMalaise
* Muscle aches
* Vomiting

AcuteAcute phase symptoms include:

* Restlessness followed by:
o Ecchymosis
o Generalized rash
o Petechiae
o Worsening of earlier symptoms
* Shock-like state
o Cold, clammy extremities
o Sweatiness (diaphoretic)


Nursing Care Plan for Dengue Hemorrhagic Fever (DHF)


Assessment
Assessment is the initial phase of the nurse to obtain the required data before performing nursing care. assessment in patients with "DHF" can be done with the interview technique, measurement, and physical examination. As for step-stages include:
* Identify potential sources and are available to meet patient needs.
* Assess the patient's medical history.
* Assess the increase in body temperature, signs of hemorrhage, nausea, vomiting, no appetite, heartburn, sore muscles and joints, signs of shock (rapid and weak pulse, hypotension, cold and moist skin, especially on the extremities, cyanosis, agitation, decreased consciousness).


Nursing Diagnosis and Intervention

1. Disorders of body fluid volume is less than body requirements related to increased capillary permeability, bleeding, vomiting and fever.

Objective: Disorders of body fluid volume can be solved
Result Criteria :
* Volume of body fluids back to normal

Intervention :
* Assess the patient's general condition and the condition
* Observation of vital signs (Temperature, Pulse)
Observation * signs of dehydration
* Observations drip infusion, and the location of the insertion of intravenous needles
* Balance fluid (the fluid input and output)
* Give the patient and family encourage patients to drink plenty
* Instruct the patient's family to change his clothes soaked in patients
sweat.

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