INTRODUCTION

Dengue is one of the most common mosquito- borne viral disease. The first and second epidemics of
dengue hemorrhagic fever occurred in Manila in 1954 and 1956, followed by the third in Bangkok in 1958.
Since then Dengue has spread throughout tropical Asian countries and has expanded globally. Dengue
virus belongs to the flavivirus genus of the Flaviviridae family. The are transmitted among humans by
Aedes aegypti. There are four serotypes , namely Dengue type !, Dengue type 2,Dengue type 3,and
Dengue type 4. Infection with any of the four serotypes causes clinical symptoms that may vary in virus
virulence, and host response. And the recovery from one infection provides life-long immunity against that
particular serotype. Dengue has its progression from Dengue fever, which is a simple form of dengue
hemorrhagic fever, a condition which involves sensitive stomach, petechial, weak pulse, and internal
bleeding that can lead to black vomit or feces. If dengue hemorrhagic fever is untreated in may progress to
dengue shock syndrome, a worst from of dengue which can also result to death.

OBJECTIVES:

General Objective;

At the end of the study, the student will be able to improve not only the knowledge in the disease process
and clinical manifestations but also on how to give necessary interventip indicated to the patient. By this,
we will be able to hasten our knowledge, skills, and attitude in giving appropriate nursing care for the
patent. Through thorough research and interview, we can acquire concrete information about Dengue
Fever.

Specific Objectives:

1. To establish rapport with my client and her significant others to gain good working relationship for
this success of this case study.
2. Present reasonable introduction that will provide an overview of the disease and can be an eye-
opener of information for the readers.
3. Conduct through physical assessment of the patient in cephalocaudal manner to note other
problems of the patient to be managed.
4. Discuss the anatomy and physiology of the affected system to have a background regarding the
organ affected by the disease.
5. Provide necessary nursing care plan to prioritize the immediate problem of the patient.
6. Provide comprehensive discharge plan of the patient to ensure the continuation of the
management of the disease even after discharge.
ANATOMY AND PHISIOLOGY

The Immune System

A second line of defense is housed within the body: a finely turned immune system that recognizes and
destroys foreign substances and organism that enter the body. The immune system can distinguish
between the own tissues and outside substances called antigens. This allows cells of the immune army to
identify and destroy only those enemy antigens. The ability to identify antigen also permits the immune
system to “remember” antigens are body has been exposed to in the past: so that the body can mount a
better and faster immune response the next time any of these antigens appear.

the immune system also includes other proteins and chemicals that assist antibodies and T cells in their
work.
Among them are chemicas that alert phagocytes to the site of of the infection. The complement system, a
group of proteins that normally flaot freely in the blood, move toward infections, where they combinetohelp
destroy microorganisms and foreign particles. They do this by changing the surface of bacteria or other
microorganisms, causing them to die

 ENZYME(EN-zime) isa protein that helps speed up a chemical reaction in the body.
 ANTIGENS (AN-tih-jens) are substances that are recognized as a threat by the body’s immune
system, which triggers the formation of specific antibodies against the substance.
 BONE MARROW is the soft tissue inside bones where blood cells are made.
 LYMPHATIC SYSTEM is a system that contains lymph nodes and network of channels that carry
fluid and cells of the immune system through the body.

The blood that flows through this network of veins and arteries is whole blood, which contains three types
of blood cells;

1. RED BLOOD CELLS (RBCs)

- (also called erythrocytes) are shaped like slightly indentent, flattened disks. RBCs contain the
iron-rich protein hemoglobin. Blood gets its bright red color when hemoglobin picks up oxygen in
the lungs. As the blood travels through the body, the hemoglobin releases oxygen to the tissues.

2. WHITE BLOOD CELLS (WBCs)

- (also called leukocytes) are key of the part body’s system for defending itself against infection.
They can move in and out of the bloodstream to reach affected tissues. Blood contains far fewer
WBCs than red blood cells, although the body can increase WBC production to fight infection.

3. PLATELETS

- (also called thrombocytes) are tiny oval- shaped cells made in the bone marrow. They help in the
clotting process. when a blood vessels breaks platelets gather in the area and help seal off the
leak. Platelets survive only about 9 days in the bloodstream and are constantly being replaced by
new cells.
 PATHOPHISIOLOGY

PREDISPOSING FACTOR

PRECIPITATING FACTOR

bite of Aedes Aegypti

virus penetration to skin

virus infects replicate inside the Langerhans cells (immunity of the skin)

Langerhans cell release interferon (to limit the spread of infection)

infected Langerhans cells go to the lymphatic (alert the immune system)

then goes to the circulation

result in viremia (high level of virusin bloodstream

activation of immune response Lymphocytes

Neutrophils and white blood cells

release pyrogen

reset hypothalamus

fever increase blood pressure in vessel

rash
DESCRIPTION OF THE DISEASE

DENGUE FEVER

Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease caused by any one of
four closely related dengue viruses. These viruses are related to the viruses that cause West Nile infection
and yellow fever.

Dengue fever is transmitted by the bite of an Aedes mosquito with a dengue virus. the mosquito becomes
infected when it bites a person with dengue virus in their blood. It can’t be spread directly from one person
to another person.

Symptoms of dengue fever

Symptoms, which usually begin four to six days after infection and last for up to 10 days, may include

Book base Patient base

• sudden, high fever  on and off fever for 5
• severe headaches days
• pain behind the eyes
• severe joint and muscle
pain
• fatigue
• nausea
• vomiting
• skin rash, which appears
two to five days after the onset of
fever
• mild bleeding( such a
nose bleed, bleeding gums, or
easy bruising)

TREATMENT

 There is no specific treatment for dengue or dengue hemorrhagic fever. Only symptomatic
treatment is given.

PREVENTION

 cover containers
 use mosquito nets, sprays
 wear full sleeves
 fumigation

DIAGNOSES

 antibody detection
 antigen detection
 RNA detection
 viral isolation
BIOGRAPHICAL DATA

Patient JB is a 13 years of age, male and residing at San Antonio, City of Ilagan. He is a Roman Catholic,
Single and a high School students. With a admitting diagnosis of dengue fever with warning sign.

HISTORY TAKING

Past health history

Patient JB is a fully immunized child of BCG,DPT,OPV when he is a child. He usually suffering of cough
and colds and fever but he seek self-medication but sometimes he went up to RHU for cheked up.

History of present illness

Prior to admission patient JB was suffering of on and off fever for 5 days. He went in GFNDY with his
father for checked up. He admitted in GFNDY last January 15,2019. Prior to admission the platelet of the
patient is decrease and was diagnosed Dengue Fever with warning sign.

Social History

Patient JB is the youngest among 5 siblings he live with his parents. He loves to play basketball and biking.
He go to play basketball if he has no class like saturday and Sunday. He expresses worry his condition and
concern to his family but states no difficulty with dealing with his condition. He has a a good relationship
with his family. According to him, he is very anxious of his condition. He copes with his condition by taking
enough rest and sleep and following doctor’s orders.

11 GORDON’s functional health pattern

Functional health pattern Before hospitalization During hospitalization

Health perception/health  “dati masigla ako
management pumapasok sa school at
tinutulungan ko pa ang
tatay ko sa bukid pag
sabado” verbalized by
the patient.
Nutritional /metabolic  He usually eat 3 times a
pattern day such as vegetables,
meat, fish. He loves
street foods.
 “hindi n ako makapasok sa school
kase my sakit na ako” according to
the patient
 He cannot eat well because of his
condition. He cannot eat dark color
foods such as chocolate, grapes,
brownies etc. .He eat a lot of fruits
to boost his immunity.

Elimination pattern  he defecate every day  he urinate 4-5 times a day.he

Exercise and activity
pattern
Sleep/rest pattern
before foing to school defecate normally everyday.
and urinates 5 times a
day.
 his daily routine is going  he watching movies in the phone.
to school ,doing his
homework and doing
some household choresl.
 he usually sleeps at  he sleep at around 8-9 and wake
around 9-10pm and he up 7am and just wake up in the
wake up 5;30am. midnight for the medication and
VS taking.
Cognitive/perceptual  the patient is a high  he is able to respond to the
pattern school student. he can question with right answer and
read and write. he can hear clearly and soft voice.
speak clearly and hear
clearly.
 he described himself as  he is strong and brave to fight his
a responsible, and good condition.
Self-perception/self- boy.
concept pattern
Role relationship pattern  he lives with his father  he and his family are united and
and mother. he is the help him for his condition.
youngest child and
source of joy and
strength of her family.

Sexual pattern  he don’t have experience  he don’t have experience and

and doesn’t fully doesn’t fully understand about
understand about having having a girlfriend
a girlfriend
Coping stress pattern  he doesn’t fully identify  he doesn’t fully identify stressors
stressors
Values/beliefs  he is a roman catholic  he cannot go to church because of
and sometimes go to his condition but he believe in
church with her family. Almighty God is the best doctor
and healer.
DIAGNOSTIC TEST AND LABORATORY TEST
TABLE OF CONTENTS

i. INTRODUCTION

ii. OBJECTIVES

iii. ANATOMY AND PHISIOLOGY

iv. PATHOPHISIOLOGY

v. DESCRIPTION OF THE DISEASE

CLINICAL MANIFESTATION

TREATMENT

vi. HISTORY TAKING

vii. GORDON’S 11 FUNCTIONAL PATTERN

viii. PHYSICAL ASSESSMENT

ix. LABORATORY TEST

x. DRUG STUDY

xi. NURSING CARE PLAN

 ST. FERDINAND COLLEGE
COLLEGE OF HEALTH SCIENCES
Sta. Ana St., City of Ilagan, Isabela 3300
“CHS is a holistic department with dynamic staff who intend
to produce globally competitive Health Care Provider”

In Partial Fulfillment

Of the Course Requirement

_________________________________________________________________

In

RLE(104)

Case study

On

DENGUE FEVER

______________________________________________________________

Presented to:

MR. NESTLEE CABACAN RN, MSN, PhD. NS

(Clinical Instructor)

Presented by:

Glesie C. Francisco
(BSNIII)