GENERAL OBJECTIVES: To be knowledgeable about the nature of Dengue Fever Syndrome, management and treatment to be able to render effective

e nursing care to the client.

SPECIFIC OBJECTIVES: This case presentation seeks to provide different information about the disease to be presented and about the client being considered with the following specific objectives: Give a brief introduction about Dengue hemorrhagic fever together with its signs and symptoms. Present the clients demographic data and health history with its Gordons pattern of functioning. Present the abnormal results of the Physical Assessment made on the client. Present the different laboratory results or test done to the client with its interpretation. Discuss the normal Anatomy and Physiology of the Blood. Explain the Pathophysiology of Dengue Hemorrhagic Fever Discuss the drugs prescribed to the client by a Drug Study. Present an appropriate Nursing Care Plan for the most prioritized problem. Give a Discharge Plan that the client may use upon discharge to the hospital

INTRODUCTION Dengue hemorrhagic fever is an acute febrile diseases found in tropics.It is a complication of Dengue fever with hemorrhages. It is characterized by abnormal vascular permeability, hypovolemia and abnormal blood clotting mechanism. The Dengue virus type 1,2,3,4, along with other arboviruse which are chikungunya, O nyong-nyong, west nile and flavi virus are classified as the causative agents. The vector responsible for the transmission of the virus is the domestic, day- biting mosquito known as the Aedes aegypti. Clinical manifestations according to its grade are persistent high fever, complains of pain, nausea and vomiting, and pathological vascular changes which is classified as Grade I, Grade II is persistence of signs and symptoms of Grade I with bleeding while Grade III has additional signs of circulatory failure and Grade IV with signs and symptoms of hypovolemic shock that can lead to death. Diagnostic test used to determine DHF are Rumpel leads test otherwise known as Tourniquet test and platelet count test that is shown in hematology examination.Treatment is mainly symptomatic and supportive.

PATIENTS PROFILE: Patient A, 4 y.o, female, Roman Catholic, Filipino from Paradise II Banilad Cebu City, was admitted for the third time in CCMC last July 10,2012 11:30AM with a chief complaint of fever and cough, poor appetite and body malaise. 4 days prior to admission Patient had experienced on-and-off fever, the mother gave the patient OTC medications like paracetamol. According to her grandmother, the patient was admitted last 2011 because of her cough.

ANATOMY and PHYSIOLOGY: BLOOD

Blood- a connective tissue composed of a liquid extracellular matrix called blood plasma that dissolves and suspends various cells and cell fragments. 1 - Formed elements: Red blood cells (or erythrocytes) White blood cells (or leucocytes) Platelets (or thrombocytes)

2 - Plasma = water + dissolved solutes Major Functions of Blood: Distribution & Transport Regulation (maintenance of homeostasis) Protection RBC biconcave disk shape a hemoglobin carrier anucleate No mitochondria 120 lifespan erythropoietin is the hormone that stimulates RBC production WBC or Leukocytes

protection from microbes, parasites, toxins, cancer 1% of blood volume; 411,000 per cubic mm blood amoeboid motion chemotaxis leukocytosis leukopoiesis Colony stimulating Factors and interleukins-stimulates white blood cell formation

PLATELETS formed in the bone marrow from cells called megakaryocytes very small, 2-4 microns in diameter approximately 250-500,000 per cubic millimeter essential for clotting of damaged vasculature Thrombopoietin stimulates the production