CASE #3

A 4-year old toddler was sent to the emergency department, febrile 39.9 degrees Celsius for 2 days. Her parents stated that the fever started when they
arrived home after a vacation from their province. The ED resident ordered CBC, Dengue IgG and IgM and Dengue NS1, which revealed Platelet of 39, 000,
Dengue IgG is positive, while dengue IgM is negative. The doctors already explained to the parents that a blood transfusion of platelet concentrates is needed
to increase the platelet level to normal levels. However, the parents declined to have the blood transfusion for strict religious belief and tradition. The doctors
repeated the explanation, but still the parents declined firmly.

The patient was transferred to the pediatric unit with bleeding precaution. Her platelet counts decreased from the initial 39, 000 to 16, 000 in 2 days of
hospitalization while the patient is still having fever. Again, the parents declined any form of blood transfusion.

NURSING DIAGNOSIS GOAL INTERVENTIONS EXPECTED OUTCOME

(List 5 unique to the given Nursing Dx)

Actual
Hyperthermia related to inflammatory
response from viral infection
Risk/Potential
Short Term
After 4 hours of nursing intervention,
the patient will manifest:
 Vital signs within normal
range
 Free of complications such as
irreversible brain and
neurological damage, acute
renal failure.
Short term
 Monitor BP and invasive
hemodynamic parameters if
available (e.g., mean arterial
pressure- MAP, CVP, PAP,
PCWP)
 Monitor respirations
 Monitor heart rate and rhythm
 Note presence / absence of
sweating
 Provide TSB q 15 minutes
At the end of 4 hours nursing
intervention, the objectives have been
partially met as evidenced by:
 Vital signs within normal
range
 Be free of complications such
as irreversible brain and
neurological damage, acute
renal failure.

Psycho-social Long Term