Ineffective Tissue Perfusion A mosquito which carries the dengue virus is called Aedes aegypti.

The said mosquito comes in contact with a person and bites the person. The dengue virus will flow through the blood stream and destroys blood components. Patients with dengue often has decreased WBC, platelet & haemoglobin count. Hemoglobin count is used to measure oxygen carrying capacity of the blood. Hemoglobin carries oxygen. Therefore, if there is decreased haemoglobin, there is also decreased oxygen that reaches the different tissues of the body.

ASSESSMENT Subjective: (none) Objective: Decreased WBC Decreased platelet Decreased HgB Decreased capillary refill time Dysrhythmias Altered LOC Fever Chills Diaphoresis

NURSING DIAGNOSIS Ineffective tissue perfusion related to decreased HgB concentration in the blood secondary to DHF 1

OBJECTIVES Short Term: After 4 hours of NI, the pt will demonstrate behaviours to improve circulation. Long Term: After 4 days of NI, the pt will demonstrate increased perfusion as appropriate

NURSING INTERVENTIONS Establish Rapport Monitor Vital Signs Assess patients condition Note customary baseline data Determine presence of dysrhythmias Perform blanch test Check for Homans sign Note presence of bleeding Elevate HOB Encourage quiet & restful atmosphere

RATIONALE To gain pts trust To obtain baseline data To assess contributing factors For comparison with current findings To identify alterations from normal To identify / determine adequate perfusion To determine presence of thrombus formation To determine risk of anemia To promote circulation To promote comfort & decrease tissue O2demand To decrease cardiac workload To enhance venous return To decrease tension and anxiety level To treat underlying cause

EXPECTED OUTCOME The pt shall have demonstrated behaviours to improve circulation The pt shall have demonstrated increased perfusion as appropriate

Instruct to avoid tiring activities Encourage light ambulation Encourage use of relaxation techniques Administer medications