Dengue Hemorrhagic Fever

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Objective
At the end of the session the learner will be able to: define Dengue Hemorrhagic Fever Discuss the pathophysiology Enumerate the signs and symptoms discuss the treatment and prevention for Dengue Hemorrhagic Fever
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What is dengue hemorrhagic fever?

is a severe, potentially deadlyinfection spread by certainmosquitoes (Aedes aegypti) is an acute infections diseasemanifested initially with fever Are acute febrile diseases,found in the tropics and Africa,with a geographical spreadsimilar to malaria.
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1. Fever, bladder problem, constant headaches, severe dizziness and loss of appetite. 2.Hemorrhagic tendency (positive tourniquet test, spontaneous bruising,bleeding from mucosa, gingiva, injection sites, etc. vomiting blood, orbloody diarrhea)

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3.Thrombocytopenia (<100,000 platelets per mm or estimated as less than3 platelets per high power field) 4. Evidence of plasma leakage (hematocrit more than 20% higher thanexpected, or drop in hematocrit of 20% or more from baseline following IV fluid, pleural effusion, ascites, hypoproteinemia)
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 In other words, dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock). DHF is also called Philippine, Thai, or Southeast Asian hemorrhagic fever and dengue shock syndrome.
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Signs and Symptoms

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable,restless, and sweaty. DHF is characterized by a fever that lasts from2 to 7 days, with general signs and symptomsthat could occur with many other illnesses. Fever Respiratory symptomsHeadacheSore throatAbdominal pain

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Other symptoms include: fever chills constant headaches bleeding from nose, mouth or gums; severe dizziness loss of appetite

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How are dengue and dengue hemorrhagic fever spread?

Dengue is transmitted to people by the bite of an Aedes mosquito that is infected with a dengue virus. The mosquito becomes infected with dengue virus when it bites a person who has dengue or DHF and after about a week can transmit the virus while biting a healthy person. Dengue cannot be spread directly from person to person.

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Diagnosis
The diagnosis of dengue is usually made clinically. The classic picture is high fever with no localizing source of infection, a petechial rash with thrombocytopenia and relative leukopenia. Serology and polymerase chain reaction (PCR) studies are available to confirm the diagnosis of dengue if clinically indicated.
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How is dengue fever treated?

Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms. Rehydration with intravenous(IV) fluids is often necessary to treat dehydration. IV fluids and electrolytes are also used to correct electrolyte imbalance. A transfusion of fresh blood or platelets can correct bleeding problems. Oxygen therapy may be needed to treat abnormally low blood oxygen.
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Prevention
Hemorrhagic fevers can be prevented through vector control and personal protection measures. Attempts have been made in urban and settled areas to destroy mosquito and rodent populations. In areas where such measures are impossible, individuals can use insect repellents, mosquito netting, and other methods to minimize exposure.
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 The emphasis for dengue prevention is on sustainable, community-based, integrated mosquito control, with limited reliance on insecticides. Preventing epidemic disease requires a coordinated community effort to increase awareness about dengue/DHF, how to recognize it, and how to control the mosquito that transmits it. Residents are responsible for keeping their yards and patios free of sites where mosquitoes can be produced.

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Nursing Diagnosis
1.The increase in body temperature related to the process of dengue virus infection 2. Deficit fluid volume related to the migration of intravascular fluid into extravascular. 3. Impaired nutrition: less than body requirements related to the decreased appetite.
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Nursing Interventions
The increase in body temperature related to the process of dengue virus infection. Goal: The body temperature returned to normal Expected Results: -Vital signs within normal limits, especially temperature (36 C - 37 C) -Mucous membranes moist.
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 Observation of vital signs every 1 hour Rationale: Determining the continued intervention when changes Encourage clients to drink lots of 15002000ml

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