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Dengue Hemorrhagic fever (DHF)

Nama Dosen : Ika Setya Purwanti, S.KM., M.Epid

Oleh :

Nama : I Putu Dian Pratama

NIM : 213221277
Kelas : B14-B

PROGRAM STUDY KEPERAWATAN PROGRAM SARJANA

SEKOLAH TINGGI ILMU KESEHATAN
WIRA MEDIKA BALI
DENPASAR
202I
DEFINITION
Dengue fever is an acute febrile illness dengue fever caused by dengue virus, which entered
into the human circulatory system through mosquito bites from the Aedes type, ie Aedes aegypti
or Aedes albopictus. Dengue is often found in the tropical and suptropis throughout the world.
Dengue fever is endemic at the time of the air will be humid, especially when the rainy season.
Even worse if the immune system has been formed by the first infection it will to be emergence of
symptoms of dengue fever is more severe when the infected for a second time.

ETIOLOGY
Dengue virus carried by the Aedes aegypti mosquito (female) and a aedes albopletus as a
vector to humans through mosquito bites are infections that can the first time members as dengue
fever symptoms with the primary symptoms of fever, sore muscles / joints

SYMPTOMS
High heat for 2-7 days.
Bleeding under the skin
Pteachie primarily
Hemorrhage
Hematoma
Ekhimosis
Epitaksis
Nausea
Vomiting
No appetite
Diarrhea
Constipation.
More muscles, bones, joints, abdomen, and heart failure
Headaches
Swelling around the eyes
Enlarged liver and lymph
Lymph nodes
Signs (decreased blood pressure, anxiety, rapid and weak pulse.)
Tourniquet test positive
After the third day is usually fever is going down and the patient may feel is cured but after that
fever can strike back
Dysentery and nose bleeds
Thrombocytopenia

PATHOPHYSIOLOGY OF DHF
The main pathophysiology of DHF or DSS are plasma leakage due to increased vascular
permeability, so that the movement of plasma into the extravascular space. If not handled properly,
it is often more severe complications to death. There are two major pathophysiological changes
that occur in DHF. The first is an increase in vascular permeability which increases the loss of
plasma from the vascular compartment. This situation causes hemoconcentration, low pulse
pressure, and other signs of shock. The second change is a disorder that includes changes in
vascular hemostasis, thrombocytopenia and coagulopathy. Platelet destruction occurs in the
qualitative and quantitative platelet count during the acute phase of dengue can be discarded.
Therefore, although the platelet count was 100,000 / mm3, still bleeding time can be extended.

CLASSIFICATION OF DHF
DHF are classified into 4 degrees, where the degree Ill and IV are considered as DSS. The
presence of thrombocytopenia, accompanied hemo consentration distinguish stage I and Il of
regular dengue fever.
• Grade 1: Fever accompanied by non-specific symptoms, the only manifestation of bleeding is a
positive tourniquet test and / or easy bruising.
• Grade I: Spontaneous bleeding in addition to bleeding manifestations in the first degree, usually
in the form of skin bleeding or other bleeding.
• Grade Ill: There was a failure of the circulation with clinical symptoms of rapid pulse, a weak
and narrowing of pulse pressure or hypotension, Skin cold, damp and anxious.
• Grade IV: severe shock with blood pressure or pulse is not detected.
COMPLICATION OF DHF
- Encephalopathy
- Liver damage
- Convulsion
- Shock

PHYSICAL EXAMINATION OF DHF

There are several physical examination conducted for dengue hemorrhagic fever are:
• The enlargement of the liver (Hepatomegaly)
• Skin Rashes
• Eyes reddened
• Throat reddened

Tests Conducted
• Examination of arterial blood gases
• Examination of blood kuagulation
• Electrolysis
• Calculate hematocrit
• Liver enzymes
• The number of platelets
• Serology
• Test Tourniquet
• X-ray chest possibility of pleural effusion

TREATMENT OF DHF
Until now there is no specific cure or vaccine for dengue hemorrhagic fever deal with the
virus, the only treatment is to treat the symptoms that occur.
• Provision of fresh blood or platelet transfusions can correct bleeding problems.
• Fluids Intravenous (IV) and electrolytes are also used to correct electrolyte imbalances.
• Oxygen therapy may be needed to cope with abnormally low blood oxygen.
• Rehydration with intravenous fluids (IV) is often necessary to treat dehydration.
• Supportive care in the Intensive Care Unit (ICU).

PREVENTION OF DHF
As for the things that you can do to prevent the outbreak of dengue disease is to wear
clothing that protects your body, especially the hands and feet, and if possible, travel during periods
of minimal mosquito activity. Mosquito abatement programs can also reduce the risk of infections
such as fogging in the neighborhood and do not forget the slogan 3M plus of government.
Terms 3M (Closes, drain, and burying) has long been programmed by the Ministry of
Health / Ministry of Health since the 80s, and now the slogan is tumed into 3M plus. Plus here
means keeping fish-eating larvae, sowing larvicides, use mosquito nets when sleeping, put gauze
on home ventilation, spraying mosquitoes with insecticides, installing insect repellent containing
DEET (N, N-Diethyl-meta-toluamide) and check the larvae are periodically.