Nursing Interventions:

1. Assess for signs and symptoms G.I bleeding. Check

for secretions. Observe color and consistency of
stools or vomitus.
2. Observe for presence of petechiae, ecchymosis,
bleeding from one more sites.
3. Monitor pulse, blood pressure.
4. Note changes in mentation and level of
consciousness.
5. Avoid rectal temperature, be gentle with GI tube
insertions.
6. Encourage use of soft toothbrush, avoiding straining
for stool, and forceful nose blowing.
7. Use small needles for injections. Apply pressure to
venepuncture sites for longer than usual.
8. Recommended avoidance of aspirin containing
products.
9. Managing nose bleeds. Elevate position of the
patient and apply ice bag to the bridge of the nose
and to the forehead.
10. Trendelenburg position. Place the patient
in Trendelenburg position to restore blood volume to
the head.
Collaborative:

1. Monitor Hb and Hct and clotting factors.

Medical Management

The management of DHF is actually simple as long as it is detected early.

 Oral rehydration therapy. Oral rehydration therapy is recommended

for patients with moderate dehydration caused by high fever and
vomiting.
 IV fluids. IVF administration is indicated for patients with dehydration.
 Blood transfusion and blood products. Patients with internal or
gastrointestinal bleeding may require transfusion, and patients with
coagulopathy may require fresh frozen plasma.
 Oral fluids. Increase in oral fluids is also helpful.
 Avoid aspirins. Aspirin can thin the blood. Warn patients to avoid
aspirins and other NSAIDs as they increase the risk for hemorrhage.