GANACA EDEN M.

BSN 3-H
DENGUE HEMORRHAGIC FEVER

DEFINITION

Is also known as breakbone fever. It occurs widely in the tropics.

Dengue fever is a flu-like illness spread by the bite of an infected
mosquito.Dengue hemorrhagic fever is a severe, often fatal, complication
of dengue fever.

ETIOLOGIC AGENT

Dengue is spread by the bite of an Aedes mosquito. The mosquito

transmits the disease by biting an infected person and then biting
someone else.

SOURCE OF INFECTION

• Immediate source is a vector mosquito Aedes Aegypti or common

household mosquito.
• Infected person.

DESCRIPTION

• First 4 days- abruptly high fever abdominal pain headache

accompanied by vomiting and epistaxis.
• 4th to 7th days- lowering of temperature. Abdominal pain
hematemesis or melena. Unstable BP narrow pulse.
• 7th to 10th days- recovery stage. Blanching appetite and BP stable.

SIGNS AND SYMPTOMS

Dengue fever usually starts suddenly with a high fever, rash, severe
headache, pain behind the eyes, and muscle and joint pain. The severity
of the joint pain has given dengue the name "breakbone fever." Nausea,
vomiting, and loss of appetite are common. A rash usually appears 3 to 4
days after the start of the fever. The illness can last up to 10 days,
but complete recovery can take as long as a month. Older children and
adults are usually sicker than young children. The blood vessels start to
leak and cause bleeding from the nose, mouth, and gums. Bruising can be
a sign of bleeding inside the body. Without prompt treatment, the blood
vessels can collapse, causing shock (dengue shock syndrome).

DIAGNOSTIC TEST

TORNIQUET TEST

Inflate the cuff on the upper arm for5 minutes. Release cuff and make
an imaginary 2.5 cm at antecubital fossa. Count the petechiae per 2.5
cm.

A physical examination may reveal:

• Enlarged liver (hepatomegaly)

• Low blood pressure
• Rash
• Red eyes
• Red throat
• Swollen glands
• Weak, rapid pulse

TREATMENT

1. A transfusion of fresh blood or platelets can correct bleeding

problems
2. Intravenous (IV) fluids and electrolytes are also used to correct
electrolyte imbalances
3. Oxygen therapy may be needed to treat abnormally low blood
oxygen
4. Rehydration with intravenous (IV) fluids is often necessary to
treat dehydration
5. Supportive care in an intensive care unit/environment
6. Encourage bed rest and maintenance of fluids to prevent
dehydration.
7. Control fever with acetaminophen. Headache, back pain and
muscle aching may be so severe as to require narcotics. Aspirin
(acetylsalicylic acid), aspirin-containing drugs, and other
nonsteroidal anti-inflammatory drugs (e.g., ibuprofen) should be
avoided because of their anticoagulant properties.
PREVENTION

There is no vaccine to prevent dengue. Prevention centers on avoiding

mosquito bites when traveling to areas where dengue occurs and when in
U.S. areas, especially along the Texas-Mexico border, where dengue
might occur. Eliminating mosquito breeding sites in these areas is
another key prevention measure.

Avoid mosquito bites when traveling in tropical areas:

• Use mosquito repellents on skin and clothing.

• When outdoors during times that mosquitoes are biting, wear long-
sleeved shirts and long pants tucked into socks.
• Avoid heavily populated residential areas.
• When indoors, stay in air-conditioned or screened areas. Use
bednets if sleeping areas are not screened or air-conditioned.
• If you have symptoms of dengue, report your travel history to
your doctor.

Eliminate mosquito breeding sites in areas where dengue might occur:

• Eliminate mosquito breeding sites around homes. Discard items

that can collect rain or run-off water, especially old tires.
• Regularly change the water in outdoor bird baths and pet and
animal water containers.

NURSING CARE

• For Hemorrhage- keep patient at rest and maintain elevated

position and promote vasoconstriction.
• Diet- low fat. Low fiber. Non-carbonated. Noodle soup may be
given.
• Make the patient wear clothing that adequately covers the arms
and legs, especially during the early morning and late afternoon.
• Apply insect repellent to both skin and clothing.

REACTION PAPER

As we all know Dengue Hemorrhagic fever is fatal especially to young

children. To prevent wide spread of Dengue people must be aware of of

the preventive measure advertised on television and broadcasted on the

radio. The practice of proper handwashing before and after handling or

have direct contact must be imposed.Through this the spread of the

virus can be minimized and control.The most convenient task to do is to

eradicate vectors at home or even in offices or other public places.

Avoid having contact with the infected person and in stagnant waters.

Clean all materials that can be the breeding site of these

vectors.Cooperate with the health personnel and follow their advise. For

me involving in health teaching is a great opportunity as well as a

pleasure to help others regarding the prevention of Dengue because

there is no vaccine for dengue. Thus, prevention has to be concentrated

on avoiding contact with the hosts, or on taking particular efforts to

safeguard oneself when caring for an infected patient, such as family

members or healthcare personnel. Thus, it is important to isolate

infected patients in the hospital, in order to prevent the spread of VHF

to other inpatients.