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Saturday, December 3, 2011

Nursing Management for Dengue Hemorrhagic Fever (DHF)

Definition

Dengue is a tropical virus disease transmitted by mosquitoes and characterized by fever, headache, pain in the limbs, and rash (Brooker, 2001).

Dengue fever is a disease primarily in children, adolescents, or adults, with clinical signs of fever, sore muscles, or joints accompanied by leukopenia, with / without rash (rash) and lymphadenopathy, biphasic fever, severe headache, pain on the movement of the eyeball, taste menyecap impaired, mild thrombocytopenia, and bleeding spots (ptekie) spontaneous (Noer, et al, 1999).

Dengue hemorrhagic fever is a disease caused by dengue viruses (arboviruses) that enters the body through the bite of the mosquito Aedes aegypti (Suriadi & Yuliani, 2001).


Pathophysiology

Dengue virus enters the body through the bite of aedes aegypti mosquito and then reacted with the antibody and virus-antibody complexes formed in circulation will activate the complement system (Suriadi & Yuliani, 2001).

Dengue virus enters the body through mosquito bites and infection first causes dengue fever. Body reaction is a reaction commonly seen in infections by viruses. A very different reaction would seem, when someone gets repeated infections with different dengue virus types. And DHF can occur when a person is infected after the first time, got the other dengue virus infection recurs. Re-infection will cause an anamnestic antibody reaction, giving rise to the concentration of antigen-antibody complex (virus-antibody complexes) is high (Noer, et al, 1999).

A. Nursing Assessment of Dengue Hemorrhagic Fever (DHF)


1. Identity
Dengue Hemorrhagic Fever (DHF) is a tropical disease that often causes the death of children, adolescents and adults (Effendy, 1995).

2. Main complaint
Patients complain of fever, headache, weakness, heartburn, nausea and decreased appetite.

3. History of present illness
Medical history showed headache, muscle pain, soreness throughout the body, pain on swallowing, weakness, fever, nausea, and decreased appetite.

4. History of previous illness
No illness in specific.

5. Family history of disease
A history of DHF disease on other family members is crucial, since DHF disease is a disease that can be transmitted through mosquito bites aigepty aides.

6. Environmental Health History
Normally less clean environment, lots of clean water puddles like tin cans, old tires, where the drinking water of birds that are rarely changed the water, the tub is rarely cleaned.

7. Historical Growth

Physical Examination for Dengue Hemorrhagic Fever (DHF)


2. Nursing Diagnosis of Dengue Hemorrhagic Fever (DHF)



1. Hyperthermia related to dengue virus infection process.

2. Risk for fluid deficit related to movement of the intravascular to the extravascular fluid.

3. Risk for fluid volume deficit related to excessive bleeding, intravascular to the extravascular fluid displacement.

4. Risk for impaired nutritional needs less than body requirements related to inadequate nutritional intake due to nausea and decreased appetite.

5. Risk for hemorrhage related to a decrease of blood clotting factors (thrombocytopenia).

6. Anxiety: parents related to the child's condition.

7. Knowledge deficit: about disease, prognosis, the effect of the procedure, and the care of sick family members associated with less exposure / recall information.

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