Dengue Fever Syndrome

AYO, Al-Hanouf 4A-BSN

Requirement in: CSMC-ER

Mrs. Anastacio, RN
LEGEND: * (asterisk) patientrelated PERSONAL DATA Name: Red box signs and Age: 9 symptoms Gender: Male Orange connectors Weight: 30 kg main facts Height: 134 cm Pink connectors The patient had on and off fever from Sunday until Thursday morning. At the early evening before the admission, the patient additional facts

SCOPE AND LIMITATION The case was from an emergency room. This limits the student from having a thorough assessment and laboratory results. Pre-admission diagnosis was made and this was the students basis for the case studys topic.

OBJECTIVES OF THE STUDY

1.

To be able to know what Dengue Fever Syndrome is. 2. To familiarize with the system involved which include the Anatomy and Physiology of the

vomited. He had complains of headache, body weakness, abdominal pain, flushing, nausea and vomiting. Upon admission at the emergency room of Cardinal Santos Medical Center at 8:50am, his temperature was 38.1 C. He was also positive in Rumpel Leads Test. The mother of the child reported that there have been incidence of Dengue Fever in her sons school and there were deaths that occurred. Dx: Dengue Fever Syndrome

3.

To discuss what procedures are needed to be done. 4. To be able to know the nursing care that is to be

Tropical country Dengue is a mosquito Rainy borne infection that in weather recent decades has Dengue become a major Fever international public health concern. It is a viral disease transmitted by Aedes mosquitoes mainly in DENGUE FEVER tropical and subtropical areas of SYNDROME the world

Mosquito bite of a tiger mosquito (Aedes Aegypti). *Dengue virus 1 or 2 or 3 or 4.

Anatomy & Physiology On page

Humans serve as the primary reservoir for dengue; however, certain nonhuman primates also serve as hosts but do not develop dengue. Mosquitoes acquire the virus when they feed on a carrier of the virus. Transmission occurs after 8-12 days of viral replication in the mosquito's salivary glands (extrinsic incubation period).

Pathophysi ology

Nursing Manage ment

Medical Management and Diagnostics

NOTE: NO specific treatment for dengue fever exists.

The mosquito can transmit dengue if it immediately bites another host. Once inoculated into a human host, dengue has an incubation period of 3-14 days (average 4-7 d) while viral replication takes place in target dendritic cells.

NURSING MANAGEMENT
Fever: Hyperthermia related to Infection (Temperature of 38.1 C, complain of headache, flushed skin, warm to touch) - Assess/Intensive monitoring of vital signs. - Tepid Sponge Bath - Promote cool environment. - Maintain bed rest to reduce metabolic demands/oxygen consumption. - Promote client safety through the use of side rails. - Do not give ASPIRIN. - Give ORESOL to replace fluid. - Administer IV fluids as ordered. sudden onset, high fever severe headache joint and muscle pain nausea

MEDICAL MANAGEMEN T/ DIAGNOSTICS Prescribe medications. Order series of tests to confirm diagnosis and infection, such as, CBC and Urinalysis.

Dengue viruses are capable of replicating in many cell types and can be detrimental to cell function.

Infection of target cells, primarily those of the reticuloendothelial system, such as dendritic cells, hepatocytes, and endothelial cells The major target for dengue virus infection in vivo appears to be cells of the monocyte/macrophage lineage. Increased capillary permeablilty

NURSING MANAGEMENT
Initiate the blood pressure cuff on the upper arm to a point midway the systolic and diastolic pressure for 5 minutes. Release the cuff and make an imaginary 2.5cm square or 1 inch square just below the cuff, at the antecubital fossa.

DIAGNOSTICS Order Rumpel Leads test to be done on the patient. Confirm the test

Capillary leakage

Positive: Tourniquet (Rumpel Leads Test) -PETECHIAE-

Count the number of petechiae inside the box A test is (+) when 20 or more petechiae per 2.5cm square or 1

Other tests that can CONFIRM dengue: Blood tests Laboratory tests, usually using a sample of your blood, are needed to confirm a diagnosis of dengue fever. If you have dengue fever, your blood may reveal the virus itself. If not, blood tests known as hemagglutination inhibition (HI) assay, enzyme-linked immunosorbent assay (ELISA) and reverse

DIAGNOSTICS

CONCLUSION

1. Dengue Fever Syndrome was

defined. 2. The system involved was reviewed. 3. The procedures that were needed to be done were discussed..

NURSING MANAGEMENT: Health Teaching Avoid unnecessary outdoor activity when mosquitoes are most prevalent, such as at dawn, dusk and early evening. Wear long-sleeved shirts, long pants, socks and shoes when you go into mosquitoinfested areas. Use mosquito repellants. The most effective repellents are those containing N,Ndiethylmetatoluamide (DEET). Use repellent with a 10 percent to 30 percent concentration of DEET to your skin. Choose the concentration based on the hours of protection you need a 10 percent concentration of DEET is effective for about two hours, whereas higher concentrations last longer. Keep in mind that chemical repellants can be toxic, and use only the amount needed for the time you'll be outdoors. Don't use DEET on the hands of young children or on infants under 2 months of age. Instead, cover your infant's stroller or playpen with mosquito netting when outside. According to the Centers for Disease Control and Prevention, oil of lemon eucalyptus, a more natural product, offers the same protection as DEET when used in similar concentrations. Patch screens if necessary, REFERENCES: Public Health Nursing in the Philippines especially where there will be night-time exposure.

World Health Organization site: http://www.who.int/mediacentre/factsheets/fs117/en/ Center for Disease Control site: http://wwwn.cdc.gov/travel/yellowBookCh4-DengueFever.aspx EMedicine site: http://www.emedicine.com/med/topic528.htm Mayo Clinic in Ohio Health site: http://www.ohiohealth.com/bodymayo.cfm?id=6&action=detail&ref=4048 UAB Health System site: http://www.health.uab.edu/15234/