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dengue fever syndrome case study

dengue fever syndrome case study

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Published by lilzette22
nursing case study
nursing case study

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Published by: lilzette22 on Jan 11, 2011
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08/03/2013

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I.
 
INTRODUCTION
Dengue fever and dengue hemorrhagic fever are acute febrile diseases. Dengue isclassified as mild, moderate and severe depending on symptoms manifested. It also hasgrading and staging from grade 1-4 based on severity and condition.Dengue hemorrhagic fever (DHF), a potentially lethal complication, was first recognizedin the 1950s during the dengue epidemics in the Philippines and Thailand. Dengue Fever iscaused by one of the four distinct virus serotypes Dengue type 1,2,3 and 4 of the GenusFlavivirus and Chikungunya Virus. Infection with one of this serotype provides immunity toonly that serotype of life, to a person living in a Dengue-endemic area can have more thanone Dengue infection during their lifetime. Dengue serotypes are transmitted by AedesAegypti through bite. It becomes infected with the Dengue Virus when it bites a person whohas Dengue and after incubation period of 6-10 days transmits the virus to healthy person.Dengue may also be transmitted via infected blood products, it cannot be transmitted ordirectly spread from person to person.Clinical manifestation of Dengue Fever in severe type are frank type flushing, suddenhigh fever, severe hemorrhage, followed by sudden drop of temperature, shock andterminating in recovery or death. For moderate type high fever and spontaneous bleedingare present. For mild slight fever, with or without petechial hemorrhage are evident.The mainstay of treatment is timely supportive therapy to tackle circulatory shock dueto hemoconcentration and bleeding. Close monitoring of vital signs in the critical period.Oral rehydration therapy is recommended to prevent dehydration in moderate to severecases. Supplementation with intravenous fluids may be necessary to prevent dehydrationand significant concentration of the blood if the patient is unable to maintain oral intake. Aplatelet transfusion may be indicated if the platelet level drops significantly or if there issignificant bleeding. The presence of melena may indicate internal gastrointestinal bleedingrequiring platelet and/or red blood cell transfusion. Aspirin and non-steroidal anti-inflammatory drugs should be avoided as these may worsen the bleeding tendencyassociated with some of these infections. Patients may receive paracetamol, acetaminophenand preparation to deal with these symptoms if dengue is suspected.The WHO says 2.5 billion people, are now at risk from dengue and estimates that theremay be 50 million cases of dengue infection worldwide every year. All persons aresusceptible and both sexes are equally affected. Dengue Fever is sporadic throughout theyear. Epidemic usually occurs during rainy seasons (June-November) peak months areSeptember-October.
 
II.
 
OBJECTIVESGeneral
This case presentation aims to identify and determine the general health problems and needs of the patient with an admitting diagnosis of Dengue Hemorrhagic Fever Type 1. This presentation alsointends to help patient promote health and medical understanding of such condition through theapplication of the nursing skills and for the students to gain knowledge, skills and attitude.
Specific
y
 
To raise the level of awareness of patient on health problems that she may encounter.
y
 
To facilitate patient in taking necessary actions to solve and prevent the identifiedproblems on her own.
y
 
To help patient in motivating her to continue the health care provided by the healthworkers.
y
 
To render nursing care and information to patient through the application of the nursingskills.
 
III.
 
NURSING HISTORY
y
 
GENERAL DATA
This is a case of CB, 5years old, male, from Pasig City. The patient is admitted for thefirst time at Rizal Medical Center last September 04, 2010 with a chief complaint of fever.
y
 
P
RESENT HEALTH HISTORY
 Three days prior to admission the patient experience intermittent fever of 38-39°C. Theyconsult to a private physician and prescribed meds of co-amoxclav. Few hours prior to admissionthe patient is still with fever, with abdominal pain and CBC done platelet is 158.
y
 
P
AST HEALTH HISTORY
 The patient is never hospitalized before. He has no allergies on any substance or food.
y
 
F
AMILY HEALTH HISTORY
 No hereditary disease can be attributed from her father side, but her mother had afamily health history of hypertension. Other than the latter, no other hereditary disease fromboth of his parents are within the patients mother knowledge.
y
 
ENVIRONMENTAL HISTORY
 The patient lives near the riverside. They have some stocks of container with water thatdoesnt have cover.
y
 
NUTRITIONAL HISTORY
The patient eats all kinds of food. He drinks 4-6 glasses a day.
y
 
ELIMINATION
P
ATTERN
Elimination pattern for bowel is once a day. He doesnt have any difficulty in urinating.
y
 
P
SYCHOSOCIAL DEVELO
P
MENT
 The patient is on his preschooler stage. He learns how to things and that doing a thing isdesirable. He learns sexual identity through awareness of genital area.

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