Part III.

Nursing Care Plan

Assessment Diagnosis Goals Intervention Evaluation

Subjective Cues: Dengue Hemorrhagic Short term goal: Preventive: A stable
I have blood coming Fever After one hour the -Inhibit the use of blood- increased on
out of my nose. And I patient manifested thinning medicines such as Platelet count
am having fever and Nursing Diagnosis: behavior of avoiding aspirin and monitor for was achieved.
joint pains, and loss of Bleeding related to injuries to prevent bleeding tendencies such as Relieved signs
appetite altered clotting factors bleeeding and there GI bleeding and symptoms
will be no more such as fever
presence of epistaxis -taking measure to promote and joint pains.
Objective Cues: or any other form of patient’s safety, including Manisfested
-Weakness bleeding removal of sharp materials good hydration
-Rashes that may injure patient status The
-Platelet count: 100 Long term goal: overall condition
-Joint pains The patient develop -applying TSB to keep patient of the Patient
-black tarry stool undertsanding the thermoregulated was improved.
disease process and
finds ways on -Recommend use of soft
preventing contact to toothbrush to reduce risk of
the disease. injury to the oral mucosa.

-Administering NSAIDS as
prescribed

-watch out for danger signs

such as: decrease level of
consciousness, hypotension,
signs of shock, eye pain,
board-like abdomen, and
perfuse bleeding

Curative:
-Administration of
medications to relieve
symptoms and to increased
patient’s immune system

-applying cold compress on

area of the nose to constrict
vessels and stop the bleeding

-Hydration through IV
therapy, to prevent shock.

-Introduce Oral fluids

Rehabilitative:
-Introduce foods rich in
Vitamins to boost immune
syste

-Foods rich in vitamin K

should be recommended to
promote blood clotting
-Watch out for bleeding
tendencies

-Maintain good hydration

-Monitor Hgb, hct, platelet

count , and other clotting
factors
 Part II. Pathophysiology

Precipitating Factors:
Predisposing Factors: Tropical Environment near rivers or near
Both males and females possible breeding grounds of mosquito

Joint pains due

Bite of Aedes Aegypti mosquito carrying virus to infiltration

Plasma leakage
Replication of virus in the blood circulation

Increase
Thrombocytopenia: Initiation of thrombocytosis brought by capillary
PC of 100 viremia permeability

Fluidshift and rash

Disseminated Altered clotting factor: increased rick for
intravascular disease
hemorrhage and shock
Edema

Hemorrhagic shock/DSS
Decreased
Increased
neutrophils
Lymphocytes
and WBC
Death

Activation of immune

Release of pyrogens

Fever: temp Loss of

Activation of inflammatory response
of 38.5 appetite
Part I. Introduction

Introduction:

Dengue (DENG-gey) fever is a mosquito-borne disease that occurs in tropical and sub-
tropical areas of the world. Mild dengue fever causes a high fever, rash, and muscle and
joint pain. A severe form of dengue fever, also called dengue hemorrhagic fever, can
cause severe bleeding, a sudden drop in blood pressure (shock) and death.

Millions of cases of dengue infection occur worldwide each year. Dengue fever is most
common in Southeast Asia and the western Pacific islands, but the disease has been
increasing rapidly in Latin America and the Caribbean.

Statistics Local:

A total of 12431cases were reported nationwide from January 1 to 26 of 2019. This is

according to the department of Health is higher compared to the numbers on the same
period last year. The regions with the highest percent increase in the number of the re-
ported cases for this year compared to last year were region X, VII, XI, IX, MIMAROPA,
CARAGA, and region XII. Age of suspect cases range from less than 1 month old to 98
years old. Majority of the cases were male. Most of the cases belonged to 5-9 years age
group.

Statistics International:

Dengue is a reportable disease in the United States; known or suspected cases should
be reported to public health authorities.
• Globally, 2.5 to 3 billion individuals live in approximately 112 countries that expe-
rience dengue transmission.
• Annually, approximately 50-100 million individuals are infected.
• Dengue fever has a mortality rate of less than 1%.
• When treated, DHF has a mortality rate of 2-5%, but when left untreated, the
mortality rate is as high as 50%.
• Dengue fever may occur at any age but is more common among children.
Assessment Diagnosis Goals Intervention Evaluation
Subjective Cues: Dengue Hemorrhagic Short term goal Preventive: A stable white
I am having fever and Fever After one hour the -Inhibit the use of blood- blood cell count
joint pains, and loss of patients tempreature thinning medicines such as was achieved
appetite Nursing Diagnosis: will decrease from 38.5 aspirin and suggested
Hyperthermia related to to 37.5 c increased
infection -Monitor for bleeding immune system
Objective Cues: tendencies such as GI and decreased
-Weakness Long term goal: bleeding viral infection
-Temp: 38.5 c There will be no signs .the patient was
-Joint pains of infection and the -taking measure to promote relieved of signs
temperature of the patient’s safety, including and symptoms
patient will be stable. removal of sharp materials such as fever
that may injure patient and joint pains.
Manisfested by
-applying TSB to keep patient good hydration
thermoregulated status .The
overall condition
-Administering NSAIDS as of the Patient
prescribed was improved.

-watch out for danger signs

such as: decrease level of
consciusness, hypotension,
signs of shock, eye pain,
board-like abdomen, and
perfuse bleeding

-Educate Patient to clean or

empty water containers that
re prone to be a breeding
ground of dengue-carrying
mosquitos.

Curative:
-Administration of
medications to relieve
symptoms and to increased
patient’s immune system

-Hydration through IV therapy,

to prevent shock.

-Introduce Oral fluids

-administer paracetamol as
ordered by the physician

Rehabilitative:
-Introduce foods rich in
Vitamins to boost immune
system

-Bed rest

-Maintain good hydration

-Monitor WBC count and

signs of infection and also
monitor possible source of
infection
Assessment Diagnosis Goals Intervention Evaluation

Subjective Cues: Dengue Short term goal Preventive: Displayed

My mouth is dry and Hemorrhagic Fever Maintain fluid -monitor hgb, hct, pc laboratory
I have headache volume at a count. results within
Nursing Diagnosis: functional level normal range
Deficient fluid -Place the patient in for individuals.

Objective Cues: volume related to Trendelenburg position to

Dry mucosa vascular leakage. Long term goal: restore blood volume to I&O and fluid
Flushing Maintained fluid the head. are balance.

Poor skin turgor volume at a

Cracked lips functional level. Pat lips with dump cloth to No signs of
prevent cracking of lips or fluid volume
provide lip balm deficit
-watch out for danger
signs such as: decrease
level of consciusness,
hypotension, signs of
shock, eye pain, board-
like abdomen, and perfuse
bleeding

Advised to avoid caffeine

and alcohol as indicated to
reduce effects of diuresis

Curative:

-Hydration through IV
therapy, to prevent shock.

-Introduce Oral fluids

-administer paracetamol
as ordered by the
physician

Rehabilitative:
-Bed rest

-Maintain good hydration

Measure blood pressure

as indicated.

Maintain patency of
vascular access for fluid
administration or blood
replacement as indicated.
 MAKATI MEDICAL CENTER

Nursing Education Research and Development

Nurse Residency Probationary Program- Batch 54

Assignment

DENGUE HEMORRAHAGIC FEVER

A CASE STUDY

Prepared by
Sharmaine Camille M. De Leon
July 15 2019